Ultrasound Guided Serratus Posterior Superior Intercostal Plane Versus PECS II Block In Breast Surgeries

NCT06936852 | Completed DMC

• 1 other identifier: 36264PR1097/2/25
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of the study is to compare the analgesic effect of ultrasound guided serratus posterior superior intercostal plane (SPSIP) block and pectoral nerve (PECS II) block in different breast surgeries.

Conditions

Analgesia

Keywords

serratus posterior superior; pecs; breast surgery

Outcome Measures

Primary Outcomes (2)

• Total morphine consumption

  Total morphine consumption in first postoperative twenty four hour

  first postoperative 24 hour

• Bedside forced vital capacity at 2 hours after surgery

  Three measurements were taken and the highest one was recorded

  Two hours after surgery

Secondary Outcomes (6)

• NRS pain scores for breast when reaching recovery room arrival, after 2 hour, 6 hour, 12 hour, 18 hour, 24 hour at rest and during arm movement

  when reaching recovery room (average 10 minutes after surgery), after two, six, twelve, eighteen, twenty four hour

• Time to first rescue opioid dose

  24 hours after surgery

• Incidence of chronic pain at 3 and 6 months after surgery

  6 months after surgery

• Block related complications and side effects

  24 hours after surgery

• Axilla NRS pain scores evaluated at the same time points of that for breast pain

  24 hours after surgery

Study Arms (2)

SPSIP Group

ACTIVE COMPARATOR

Under complete aseptic technique, a high frequency linear probe will be placed adjacent to upper medial part of scapula to visualize the second and third ribs. The needle will be introduced with in plane approach, from caudal to cranial and 30 ml of 0.25% bupivacaine will be injected in the fascial plane between serratus posterior superior and intercostal muscles at the level of second and third ribs.

Procedure: Serratus posterior superior intercostal plane block

PECS II group

ACTIVE COMPARATOR

Under complete aseptic technique, a high frequency linear probe will be placed in the infraclavicular region, angulated and directed laterally towards the axilla to visualize the third and fourth ribs with pectoralis major, minor and serratus anterior muscles from superficial to deep. The needle will be introduced with in plane approach from medial to lateral, 10 ml of 0.25% bupivacaine will be injected in the fascial plane between pectoralis major and pectoralis minor then the needle will be further introduced to the fascial plane between pectoralis minor and serratus anterior muscles with injection of 20 ml of 0.25% bupivacaine.

Procedure: PECS II block

Interventions

Serratus posterior superior intercostal plane block PROCEDURE

Under complete aseptic technique, a high frequency linear probe will be placed adjacent to upper medial part of scapula to visualize the second and third ribs. The needle will be introduced with in plane approach, from caudal to cranial and 30 ml of 0.25% bupivacaine will be injected in the fascial plane between serratus posterior superior and intercostal muscles at the level of second and third ribs.

SPSIP Group

PECS II block PROCEDURE

. Under complete aseptic technique, a high frequency linear probe will be placed in the infraclavicular region, angulated and directed laterally towards the axilla to visualize the third and fourth ribs with pectoralis major, minor and serratus anterior muscles from superficial to deep. The needle will be introduced with in plane approach from medial to lateral, 10 ml of 0.25% bupivacaine will be injected in the fascial plane between pectoralis major and pectoralis minor then the needle will be further introduced to the fascial plane between pectoralis minor and serratus anterior muscles with injection of 20 ml of 0.25% bupivacaine.

PECS II group

Eligibility Criteria

• Age: 21 Years - 70 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age from 21 to 70 years, both male and female.
• American Society of Anesthesiologists (ASA) Physical Status Classification System I-II.

You may not qualify if:

• Any patient refuses to participate.
• Bleeding or coagulation disorders, hepatic dysfunction, psychiatric diseases.
• Chronic opioid use.
• Patients with pulmonary diseases.
• History of allergy to local anesthetics.
• Infection at the needle entry point will be excluded.

Sponsors & Collaborators

• Tanta University: lead

Study Sites (1)

Tanta University

Tanta, Select, 1234, Egypt

Location

Related Publications (1)

• Gundogdu O, Avci O, Balci F, Tekcan MN, Kol YC. Efficacy of Serratus Posterior Superior Intercostal Plane Block on Postoperative Pain and Total Analgesic Consumption in Patients Undergoing Reduction Mammoplasty Surgery: An Evidence Based Report. J Coll Physicians Surg Pak. 2024 Mar;34(3):348-350. doi: 10.29271/jcpsp.2024.03.348.

  PMID: 38462873 RESULT

MeSH Terms

Conditions

Agnosia

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Masking Details: double blinded study
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: lecturer at Anesthesia & Surgical ICU and Pain Medicine

Study Record Dates

• First Submitted: March 30, 2025
• First Posted: April 20, 2025
• Study Start: February 27, 2025
• Primary Completion: September 27, 2025
• Study Completion: March 27, 2026
• Last Updated: April 17, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

EG (1)