Effect of adding a superficial parasternal intercostal plane block to the serratus anterior plane block on postoperative analgesic outcomes in breast cancer surgery: a prospective, randomized, double-blind trial
Abstract
Background: Breast cancer surgery is frequently associated with moderate to severe postoperative pain. While the serratus anterior plane block (SAPB) provides effective anterolateral chest wall analgesia, it may inadequately cover the anterior intercostal nerve branches. This study aimed to determine whether adding a superficial parasternal intercostal plane block to SAPB improves postoperative opioid consumption, pain scores, and dermatomal sensory coverage.
Methods: In this prospective, randomized, double-blind trial, 64 patients aged 18-65 years undergoing elective breast surgery were randomly allocated into two groups. Group S (n = 32) received a preoperative SAPB with 30 mL of 0·25% bupivacaine combined with a parasternal injection of 10 mL saline. Group S + P (n = 32) received a SAPB with 30 mL of 0·25% bupivacaine plus a parasternal block with 10 mL of 0·25% bupivacaine. All patients were managed with an identical multimodal postoperative analgesia protocol. The primary outcome was postoperative opioid consumption. Secondary outcomes included visual analogue scale (VAS) pain scores, dermatomal sensory analysis and side effects.
Results: Baseline demographic characteristics and surgical variables were comparable between groups (p > 0·05). Sensory blockade of the T3, T4, and T5 dermatomes was significantly more frequent in the S + P group than in the S group (p 0·05).
Conclusions: Although the addition of a superficial parasternal intercostal plane block to SAPB…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 64 participants or records.
Read the paper
Related studies
- Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial
- Effect of a Postoperative Multimodal Opioid-Sparing Protocol vs Standard Opioid Prescribing on Postoperative Opioid Consumption After Knee or Shoulder Arthroscopy: A Randomized Clinical Trial
- Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial
- A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions
- An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
- Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.