Comparison of serratus plane block alone and in combination with pectoral type 1 block for breast cancer surgery: a randomized controlled study

Abstract

Background/Aim: Concurrent application of ultrasound-guided pectoral type 1 (PECS I) and serratus plane block (SPB) is one of the most appropriate multimodal analgesic strategies for reducing acute post-mastectomy pain. The purpose of the present study was to compare the analgesic efficacy of SPB alone, or in combination with PECS I block for postmastectomy pain following breast cancer surgery. Materials and Methods: Sixty participants undergoing breast cancer surgery were randomly assigned to two groups. After anesthesia induction, group S (n =30) received SPB alone, whereas the SPECS group (n =30) received a combination of PECS I and SPB. Pain scores at 0, 1, 2, 6, 12, 24 h postoperatively, intra-operative fentanyl consumption, postoperative time to first rescue analgesia, nausea, vomiting, patient satisfaction, and anesthesia-related complications were recorded. Results: Pain scores in the SPECS group were significantly lower than group S throughout the follow-up period (p <0.001). A significant reduction in postoperative rescue morphine consumption (p =0.01, median difference 7 mg, 95 % confidence interval: 5.1-7.9 mg) and intraoperative fentanyl consumption (p =0.01) in the SPECS group compared with group S. Moreover, postoperative nausea and vomiting were lower, and patient satisfaction was higher in the SPECS group compared with that of the group S. Conclusions: These results suggest that SPB application and PECS I provide more effective and reliable perioperative analgesia and increase patient satisfaction in breast cancer surgery