ORIGINAL ARTICLE   

Minerva Anestesiologica 2025 March;91(3):155-63

DOI: 10.23736/S0375-9393.24.18334-4

Copyright © 2024 EDIZIONI MINERVA MEDICA

lingua: Inglese

Analgesic efficacy of ultrasound-guided rhomboid intercostal block versus serratus plane block in modified radical mastectomy: a prospective randomized controlled study

Dina H. ALHASSANIN, Amr A. ELBADRY, Hoda A. EZZ ✉, Naglaa K. MOHAMED

Department of Anesthesia, Surgical Intensive Care, and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt

BACKGROUND: This research aimed to assess the analgesic efficacy of ultrasound-guided rhomboid intercostal block (RIB) or serratus plane block (SPB) versus IV opioid among modified radical mastectomy (MRM) patients.
METHODS: One hundred and five female patients aged 18-65 years with American Society of Anesthesiologists (ASA) physical status II-III scheduled for unilateral MRM were randomly allocated into three equal groups: 1) control group (received IV basal analgesia); 2) SPB group (received ipsilateral SPB); and 3) RIB group (received ipsilateral RIB).
RESULTS: Visual Analogue Scale (VAS) was significantly increased in control group compared to SPB group at Post-Anesthesia Care Unit (PACU) (1 [1-2], 0 [0-1]), 2 h (4 [3-4], 0 [0-1]), and 4 h (3 [3-4], 2 [1-2]) postoperative in control and SPB groups, respectively; and in comparison with RIB group at PACU (0 [0-1]), 2 h (1 [0-1]), 4 h, (1 [1-2]), 6 h (1 [1-2]), and 8 h (2 [1-2]), postoperative. VAS was significantly increased in SPB group at 6 h (4 [3-4]), and 8 h (4 [3.25-4]), compared to RIB group with P<0.0001. Time of first analgesic requirement (minutes) was significantly delayed in RIB (720 [480-720]) and SPB (360 [360-360]) groups in comparison with control group (60 [60-120]) and in RIB group in comparison with SPB group. The total postoperative 24 h morphine consumption (mg) was significantly increased in control group (15.69±1.64) when compared to SPB (9.6±1.42) and RIB (6.51±1.36) groups and in SPB group when compared to RIB group.
CONCLUSIONS: Both rhomboid intercostal and serratus anterior plane blocks were efficient for analgesia after modified radical mastectomy. However, RIB had better analgesic efficacy compared to SPB.

KEY WORDS: Mastectomy, radical; Anesthesia; Breast neoplasms