Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block Compared with Conventional Analgesia for Postoperative Analgesia in Breast Cancer Surgery: A Randomized Controlled Trial.

Purpose: The aim of this study was to compare the analgesic efficacy and recovery outcomes of the serratus posterior superior intercostal plane block (SPSIPB) and the serratus anterior plane block (SAPB) with conventional analgesia in patients undergoing oncoplastic breast surgery. Patients and Methods: One hundred and five patients aged 18-65 years with an ASA physical status of I-III were included in this prospective, randomized controlled study. Patients were randomly assigned in a 1:1:1 ratio to three groups: the Control Group, the SPSIPB Group, and the SAPB Group. Outcome assessors were blinded to group allocation. The primary outcome was cumulative tramadol consumption during the first 24 h postoperative. Secondary outcomes included Numeric Rating Scale (NRS) scores at rest and during activity, Quality of Recovery-15 (QoR-15) scores, and the incidence of postoperative nausea and vomiting (PONV). Results: Cumulative tramadol consumption during the first 24 h was significantly lower in the SPSIPB and SAPB groups compared with the Control Group (p < 0.001), with no significant difference between the two block groups. Although NRS pain scores were comparable among groups at all time points, QoR-15 scores were significantly higher and antiemetic requirements were lower in both block groups compared with the Control Group. Conclusion: The SPSIPB and SAPB reduced opioid consumption and improved quality of recovery compared with conventional management, despite similar pain scores, with no significant difference between the two techniques.