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

Zonguldak Bulent Ecevit University90 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Conditions

Breast Reduction Postoperative Pain

Interventions

Serratus Anterior Plane Block (SAPB)PROCEDURE

injection local anesthetic between 5th rib and serratus anterior muscle

Serratus Anterior Plane Block (SAPB) and parasternal intercostal plane blockPROCEDURE

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

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 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 Exclusion Criteria: * 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

Outcomes

Primary Outcomes

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.

Time frame: First 24 hours after surgery

Secondary Outcomes

Quality of recovery by using QoR-15 questionnaire

Time frame: postoperative 24th hour

Pain Scores

using NRS Scale

Time frame: postoperative 0, 1, 2, 6, 12, 24 th hour