Serratus vs ESP Block for Postoperative Pain in Unilateral Breast Surgery

NCT07541040 | Not Yet Recruiting

• 1 other identifier: KSH-ANREA-EC-05
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective, randomized, assessor-blinded trial compares serratus posterior superior intercostal plane block (SPSIPB) and erector spinae plane block (ESPB) for postoperative analgesia in unilateral breast surgery. 54 patients will be randomized to receive either SPSIPB or ESPB before general anesthesia. The primary outcome is postoperative pain scores within the first 24 hours. The secondary outcome is opioid consumption.

Conditions

Post Operative Pain; Opioid Use

Keywords

Post Operative Pain; Opioid Use

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Scores (NRS)

  Postoperative pain intensity will be assessed using the Numerical Rating Scale (NRS; 0-10, where 0 indicates no pain and 10 indicates worst imaginable pain). Pain scores will be evaluated both at rest and during movement (coughing)

  T0: upon arrival at recovery (Aldrete ≥9), T1: 1 hour, T2: 4 hours, T3: 8 hours, T4: 12 hours, T5: 24 hours postoperatively

Secondary Outcomes (1)

• Total Opioid Consumption

  T0-T1: 0-1 hour, T1-T2: 1-4 hours, T2-T3: 4-8 hours, T3-T4: 8-12 hours, and T4-T5: 12-24 hours postoperatively

Study Arms (2)

SPSIP Block

ACTIVE COMPARATOR

Participants will receive an ultrasound-guided serratus posterior superior intercostal plane block (SPSIPB) with 30 mL of 0.25% bupivacaine prior to induction of general anesthesia.

Procedure: Serratus Posterior Superior Intercostal Plane Block

ESPB Block

ACTIVE COMPARATOR

Participants will receive an ultrasound-guided erector spinae plane block (ESPB) with 30 mL of 0.25% bupivacaine prior to induction of general anesthesia.

Procedure: Serratus Posterior Superior Intercostal Plane Block

Interventions

Serratus Posterior Superior Intercostal Plane Block PROCEDURE

An ultrasound-guided interfascial plane block performed between the serratus posterior superior muscle and the underlying ribs prior to general anesthesia.

Also known as: SPSIPB

ESPB Block; SPSIP 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
• ASA physical status I-III
• Body mass index (BMI) between 18 and 35 kg/m²
• Scheduled for elective unilateral breast surgery (mastectomy with or without sentinel lymph node biopsy)
• Ability to understand and provide written informed consent

You may not qualify if:

• Infection at the site of block application
• Known allergy to local anesthetics
• Coagulopathy or anticoagulant therapy
• Chronic opioid use
• Pregnancy
• Inability to communicate or cooperate
• Refusal to participate
• Failed block
• Requirement of additional intraoperative analgesia outside the study protocol
• Development of serious intraoperative complications

Sponsors & Collaborators

• Engin Çetin: lead

Study Sites (1)

University of Health Sciences Kocaeli City Hospital

İzmit, Kocaeli, 41200, Turkey (Türkiye)

Location

Related Publications (1)

• Arik E, Zengin M, Seker G, Kucuk O, Gungordu E, Ozguner Y, Alagoz A, Ergil J. Is the serratus posterior superior intercostal plane block a viable alternative to the erector spinae plane block for postoperative analgesia in breast surgery? A prospective, randomized trial. BMC Anesthesiol. 2025 Nov 29;26(1):11. doi: 10.1186/s12871-025-03531-y.

  PMID: 41318393 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• Engin Çetin, M.D

  Kocaeli City Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Engin Çetin, M.D.

CONTACT

5321206004; Doccetin52@gmail.com

Engin Çetin, M.D

CONTACT

5321206004; Doccetin52@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: The patient and the outcome assessor will be blinded to group allocation. The anesthesiologist performing the block will not be blinded.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: principal investigator

Model Details: Participants will be randomized in a 1:1 ratio to receive either serratus posterior superior intercostal plane block (SPSIPB) or erector spinae plane block (ESPB).

Study Record Dates

• First Submitted: April 15, 2026
• First Posted: April 21, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): August 1, 2026
• Last Updated: April 29, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)