Parasternal Block Added to Serratus Anterior Plane Block in Breast Reduction Surgery

NCT07432256 | Completed

• 1 other identifier: 2024/08-6
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate the effect of adding a Superficial Parasternal Intercostal Plane Block (PIPB) to the Serratus Anterior Plane Block (SAPB) on postoperative pain control in patients undergoing breast reduction surgery under general anesthesia. Effective postoperative analgesia is essential to reduce opioid consumption and improve recovery. All patients will receive standard general anesthesia. Patients will be allocated into three groups: a control group receiving no regional block, a group receiving SAPB alone, and a group receiving SAPB combined with PIPB. The primary outcome of the study is total opioid consumption within the first 24 hours after surgery. Secondary outcomes include postoperative pain scores, Quality of Recovery-15 (QoR-15) scores, and intraoperative remifentanil consumption. The study aims to determine whether SAPB reduces postoperative opioid requirements compared to no block, and whether adding PIPB provides additional analgesic benefit by blocking the anterior cutaneous branches of the intercostal nerves. The findings may contribute to improving multimodal analgesia strategies in breast surgery.

Conditions

Breast Reduction; Postoperative Pain; Opioid Consumption

Keywords

serratus anterior plane block; parasternal intercostal plane block; breast reduction surgery; pain management; postoperative pain; QoR-15

Outcome Measures

Primary Outcomes (1)

• Total postoperative opioid consumption in the first 24 hours

  Total opioid consumption during the first 24 postoperative hours will be recorded and compared between the study groups.

  First 24 hours after surgery

Secondary Outcomes (2)

• Quality of recovery by using QoR-15 questionnaire

  postoperative 24th hour

• Pain Scores

  postoperative 0, 1, 2, 6, 12, 24 th hour

Study Arms (3)

control

NO INTERVENTION

patients receive standard general anesthesia

Serratus Anterior Plane Block

ACTIVE COMPARATOR

patients receive an ultrasound guided anterior serratus plane block in addition to general anesthesia before surgery

Procedure: Serratus Anterior Plane Block (SAPB)

Serratus Anterior Plane Block + Parasternal Intercostal Plane Block

ACTIVE COMPARATOR

patients receive an ultrasound guided anterior serratus plane block combined with a parasternal plane block in addition to general anesthesia before surgery

Procedure: Serratus Anterior Plane Block (SAPB) and parasternal intercostal plane block

Interventions

Serratus Anterior Plane Block (SAPB) PROCEDURE

injection local anesthetic between 5th rib and serratus anterior muscle

Serratus Anterior Plane Block

Serratus Anterior Plane Block (SAPB) and parasternal intercostal plane block PROCEDURE

both injection local anesthetic between 5th rib and serratus anterior muscle at midaxillary line and between 4th costal cartilage and pectoralis major muscle at next to the sternum

Serratus Anterior Plane Block + Parasternal Intercostal Plane Block

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Female patients aged 18-65 years
• Scheduled for elective breast reduction surgery under general anesthesia
• American Society of Anesthesiologists (ASA) physical status I-III
• Ability to understand the study and provide written informed consent

You may not qualify if:

• Patient refusal
• Known allergy to local anesthetics
• Coagulopathy or ongoing anticoagulant therapy
• Infection at the block site
• Chronic opioid use or opioid dependence
• Severe hepatic or renal insufficiency
• Pregnancy or breastfeeding

Sponsors & Collaborators

• Zonguldak Bulent Ecevit University: lead

Study Sites (1)

Zonguldak Bulent Ecevit University Hospital

Zonguldak, Maltepe, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative; Agnosia

Interventions

Saposins

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases

Intervention Hierarchy (Ancestors)

Sphingolipid Activator Proteins; Coenzymes; Enzymes and Coenzymes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: February 19, 2026
• First Posted: February 25, 2026
• Study Start: May 1, 2024
• Primary Completion: August 25, 2025
• Study Completion: December 1, 2025
• Last Updated: February 25, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)