Evaluating a Novel Regional Technique: Serratus Posterior Superior Intercostal Plane Block Reduces Opioid Consumption and Pain Scores after Breast-conserving Surgery: A Randomized Controlled Trial.

Abstract

Objective: Serratus posterior superior intercostal plane block (SPSIPB) provides thoracic analgesia. Our objective was to assess the analgesic effectiveness of SPSIPB in reducing pain scores and opioid consumption in patients undergoing breast-conserving surgery (BCS) with axillary dissection or sentinel lymph node biopsy.

Methods: Participants were individuals aged 18-65 years with American Society of Anesthesiologists physical status I-II who were scheduled for elective BCS under general anaesthesia. Participants were randomly assigned to Group SPSIPB (n = 30) or Group Control (n = 30); the control group received local infiltration anaesthesia. A total of 30 milliliters of 0.25% bupivacaine was during the SPSIPB procedure. The primary outcome of the study was the numerical rating scale (NRS) score at 1 hour postoperatively. Secondary outcomes included 24-hour opioid consumption, need for rescue analgesia, and adverse effects.

Results: During the first 24 hours after surgery, the median static and dynamic NRS scores were lower in the SPSIPB group than in the control group (P < 0.005). Fewer patients in the SPSIPB group required rescue analgesia than in the control group (3 vs. 26 patients, P=0.001), and opioid consumption was lower in the SPSIPB group (P=0.001). The incidence of adverse effects was significantly lower in the SPSIPB group (P < 0.005).

Conclusion: Opioid consumption and pain scores in the SPSIPB group were significantly lower compared with those in the control group. SPSIPB provides effective analgesia and reduces opioid requirements, offering a valuable opioid-sparing alternative for anaesthesia in breast surgery.