This prospective, single-center observational study will compare postoperative pain control in adults undergoing elective breast surgery. Ninety participants will be evaluated in three groups based on routine clinical care: rhomboid intercostal plane block, serratus posterior superior intercostal plane block, and control. The anesthesia method and fascial plane block will be selected by the treating anesthesiologist, and the research team will not assign participants to a group. The main outcome is the total amount of tramadol used through patient-controlled analgesia during the first 24 hours after surgery. Pain scores at rest and during movement, sensory block levels, postoperative nausea and vomiting, and block-related complications will also be recorded.
Patients aged 18 to 80 years who are scheduled for elective breast surgery under general anesthesia and meet the eligibility criteria will be enrolled after providing written informed consent. Group classification will reflect the regional analgesia approach selected as part of routine care by the treating anesthesiologist. The investigators will not participate in the selection of the anesthesia method, the fascial plane block, or the study group. The study will include 90 participants in three observational cohorts: rhomboid intercostal plane block, serratus posterior superior intercostal plane block, and control. The primary outcome is cumulative tramadol consumption recorded by patient-controlled analgesia during the first 24 postoperative hours. Secondary assessments include Numeric Rating Scale pain scores at rest and during movement at postoperative hours 0, 2, 4, 6, 12, and 24; sensory block level assessed by pinprick testing in the block groups; postoperative nausea and vomiting; and block-related complications.
Study Type
OBSERVATIONAL
Enrollment
90
A fascial plane block in which local anesthetic is injected into the plane between the rhomboid major and intercostal muscles. The treating anesthesiologist selects the technique as part of routine clinical care, and the type and dose of local anesthetic used are recorded.
A fascial plane block in which local anesthetic is injected into the plane between the serratus posterior superior and intercostal muscles. The treating anesthesiologist selects the technique as part of routine clinical care, and the type and dose of local anesthetic used are recorded.
Bursa Yuksek Ihtisas Training and Research Hospital
Bursa, Turkey (Türkiye)
RECRUITINGCumulative Tramadol Consumption During the First 24 Hours After Surgery
The total amount of tramadol consumed through the patient-controlled analgesia device will be recorded in milligrams at postoperative hour 24.
Time frame: During the first 24 postoperative hours
Numeric Rating Scale Pain Score at Rest
Pain intensity at rest will be assessed using a Numeric Rating Scale from 0 to 10, where 0 indicates no pain and 10 indicates the most severe pain.
Time frame: At postoperative hours 0, 2, 4, 6, 12, and 24
Numeric Rating Scale Pain Score During Movement
Pain intensity during movement, including coughing or deep breathing, will be assessed using a Numeric Rating Scale from 0 to 10, where 0 indicates no pain and 10 indicates the most severe pain.
Time frame: At postoperative hours 0, 2, 4, 6, 12, and 24
Dermatomal Extent of Sensory Block Assessed by Pinprick
Among participants in the block groups, sensory block will be assessed by pinprick, and the upper and lower dermatomal boundaries will be recorded.
Time frame: At postoperative hours 0, 2, 4, 6, 12, and 24
Incidence of Postoperative Nausea and Vomiting
The occurrence of postoperative nausea and vomiting will be recorded for each participant.
Time frame: During the first 24 postoperative hours
Incidence of Block-Related Complications
Block-related complications will be recorded among participants in the block groups.
Time frame: During the first 24 postoperative hours
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