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Breast Cancer Surgery Painbreast surgeryNCT07601490

The Effect of Nerve Blocks on Analgesia in Breast Cancer Surgery

A study testing Serratus Posterior Superior Intercostal Plane Block and Serratus anterior plane block (SAP) in people with Breast Cancer Surgery Pain, run by Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey at 1 site in Turkey (Türkiye).

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Postoperative pain following modified radical mastectomy remains a significant clinical concern and may adversely affect patient recovery, opioid consumption, and overall patient satisfaction. Read more about this study

Who is it for?
Ages 18 to 65 years, women only
Conditions the study is for
Breast Cancer Surgery Pain
What is being tested?
Serratus Posterior Superior Intercostal Plane Block and Serratus anterior plane block (SAP)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
70 participants
Where
1 siteTurkey (Türkiye)
Study dates
15 Jun 2026to 16 Oct 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Female patients aged between 18 and 65 years
  • American Society of Anesthesiologists (ASA) physical status I-III
  • Body Mass Index (BMI) <35 kg/m²
  • Normal International Normalized Ratio (INR) value and platelet count
  • Normal liver and renal function tests
  • Patients scheduled for elective modified radical mastectomy surgery

Who cannot join

  • Bleeding diathesis
  • Allergy to local anesthetic agents
  • Suspected infection or inflammation at the planned block site
  • ASA physical status IV or higher
  • Long-term medication use due to chronic pain
  • Advanced hepatic or renal failure
Show all 10Show fewer
  • Presence of severe pulmonary disease
  • Use of any opioid medication within 24 hours before surgery
  • Cognitive impairment
  • Patients undergoing revision surgery

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Dilek Metin Yamac, MD contact

+905054959792

ddilekmetin@hotmail.com

Turkey (Türkiye)1 site
  • Health Sciences University 2. Sultan Abdülhamid Han Training and Research Hospital

    Istanbul, Uskudar, 34668

    Dilek Metin Yamac, Medicine Doctor, +90216 542 20 00, ddilekmetin@hotmail.com

Other trials in Turkey (Türkiye)

About this study

Official title: Comparison of Postoperative Analgesic Efficacy of Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block in Modified Radical Mastectomy Surgery

Postoperative pain following modified radical mastectomy remains a significant clinical concern and may adversely affect patient recovery, opioid consumption, and overall patient satisfaction. Ultrasound-guided regional anesthesia techniques have gained increasing importance as part of multimodal analgesia strategies in breast surgery. The serratus anterior plane (SAP) block is a commonly used interfascial plane block for postoperative analgesia in thoracic and breast procedures. Recently, the serratus posterior superior intercostal plane (SPSIP) block has emerged as a novel regional anesthesia technique with potentially wider thoracic dermatomal spread and effective analgesic properties.

This prospective randomized controlled study aims to compare the postoperative analgesic efficacy of the SPSIP block and SAP block in patients undergoing modified radical mastectomy under general anesthesia. Patients will be randomly allocated into two groups to receive either ultrasound-guided SPSIP block or SAP block preoperatively. Primary outcomes will include postoperative pain scores and opioid consumption within the first 24 hours after surgery. Secondary outcomes will include time to first analgesic request, rescue analgesic requirements, intraoperative hemodynamic parameters, postoperative nausea and vomiting, block-related complications, and patient satisfaction.

The study is designed to evaluate whether SPSIP block provides superior postoperative analgesia compared with SAP block in modified radical mastectomy surgery.

Read the detailed description

This prospective, randomized, controlled clinical study is designed to compare the postoperative analgesic efficacy of the ultrasound-guided Serratus Posterior Superior Intercostal Plane (SPSIP) block and Serratus Anterior Plane (SAP) block in patients undergoing modified radical mastectomy under general anesthesia. Postoperative pain after breast cancer surgery remains an important clinical problem and may negatively affect respiratory function, early mobilization, recovery quality, patient satisfaction, and postoperative opioid consumption. Effective perioperative analgesia is therefore an essential component of enhanced recovery protocols in breast surgery.

Regional anesthesia techniques have increasingly been incorporated into multimodal analgesia strategies to reduce opioid-related adverse effects and improve postoperative pain control. The SAP block is widely used in breast and thoracic surgery due to its ability to provide analgesia to the lateral thoracic wall through blockade of the lateral cutaneous branches of the intercostal nerves. However, recently described fascial plane blocks such as the SPSIP block may provide broader dermatomal spread and more effective thoracic analgesia. Despite growing interest in the SPSIP block, evidence regarding its analgesic efficacy in breast surgery remains limited.

The study will include adult female patients scheduled for elective modified radical mastectomy under general anesthesia. Following enrollment and randomization, patients will be allocated to receive either ultrasound-guided SPSIP block or SAP block preoperatively in addition to standardized general anesthesia and multimodal analgesia protocols. All regional blocks will be performed under sterile conditions using ultrasound guidance by experienced anesthesiologists. Standard intraoperative monitoring will be applied throughout the surgical procedure.

Perioperative anesthetic management will be standardized as much as possible to minimize confounding factors affecting postoperative pain outcomes. Intraoperative opioid administration, hemodynamic parameters, and anesthetic requirements will be recorded. Postoperative analgesia protocols, including rescue analgesic administration criteria, will also be standardized for all participants.

The primary aim of the study is to evaluate and compare postoperative analgesic effectiveness between SPSIP and SAP blocks. Analgesic efficacy will be assessed using postoperative pain scores at predefined time intervals and cumulative opioid consumption during the postoperative period. Additional perioperative parameters related to recovery and analgesic quality will also be evaluated to determine the clinical utility of these interfascial plane blocks in breast surgery.

This study is expected to contribute to the current literature regarding novel regional anesthesia techniques for breast surgery and may help define the role of SPSIP block as an alternative or superior analgesic approach compared with SAP block in modified radical mastectomy patients.

Being tested
Serratus Posterior Superior Intercostal Plane Block, Serratus anterior plane block (SAP)
Keywords
modified radical mastectomy, Serratus Posterior Superior Intercostal Plane Block, Serratus Anterior Plane Block, Postoperative analgesia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Serratus Posterior Superior Intercostal Plane BlockProcedure or surgery

    Ultrasound-guided Serratus Posterior Superior Intercostal Plane (SPSIP) block performed preoperatively for postoperative analgesia in modified radical mastectomy surgery.

  • Serratus anterior plane block (SAP)Procedure or surgery

    Ultrasound-guided Serratus Anterior Plane (SAP) block performed preoperatively for postoperative analgesia in modified radical mastectomy surgery.

Study groups in NCT07601490
Study groupRoleWhat they receive
Serratus Posterior Superior Intercostal Plane (SPSIP) blockExperimentalParticipants assigned to this group will receive an ultrasound-guided Serratus Posterior Superior Intercostal Plane (SPSIP) block before induction of general anesthesia for modified radical mastectomy surgery. The block will be performed under sterile conditions by an experienced anesthesiologist using ultrasound guidance. Following the regional block procedure, standardized general anesthesia and postoperative multimodal analgesia protocols will be applied. Postoperative pain scores, opioid consumption, rescue analgesic requirements, and perioperative adverse events will be recorded and evaluated.
Receives: Procedure: Serratus Posterior Superior Intercostal Plane Block
Serratus Anterior Plane (SAP) blockActive comparatorParticipants assigned to this group will receive an ultrasound-guided Serratus Anterior Plane (SAP) block before induction of general anesthesia for modified radical mastectomy surgery. The block will be performed under sterile conditions by an experienced anesthesiologist using ultrasound guidance. Following the regional block procedure, standardized general anesthesia and postoperative multimodal analgesia protocols will be applied. Postoperative pain scores, opioid consumption, rescue analgesic requirements, and perioperative adverse events will be recorded and evaluated.
Receives: Procedure: Serratus anterior plane block (SAP)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Postoperative pain intensity assessed by Visual Analog Scale (VAS)

    Postoperative pain intensity will be evaluated using the Visual Analog Scale (VAS), a 10-point scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "the worst imaginable pain." VAS scores at rest and during movement will be recorded and compared between patients receiving ultrasound-guided superior posterior serratus intercostal plane (SPSIP) block and serratus anterior plane (SAP) block following modified radical mastectomy surgery. Higher VAS scores indicate greater pain severity and poorer analgesic efficacy.

    Measured: At postoperative 1, 2, 4, 8, 12, and 24 hours after surgery

Secondary outcomes (3)
  1. Intraoperative remifentanil consumption

    Total intraoperative remifentanil consumption will be recorded and compared between the SPSIP block group and SAP block group.

    Measured: During surgery

  2. Total postoperative tramadol consumption within 24 hours

    Total tramadol consumption during the first 24 postoperative hours will be recorded to evaluate postoperative opioid requirements in both groups.

    Measured: First 24 hours after surgery

  3. Postoperative nausea and vomiting (PONV) scores

    Postoperative nausea and vomiting will be assessed using a standardized Postoperative Nausea and Vomiting (PONV) severity scale ranging from 0 to 3, where 0 indicates no nausea or vomiting, 1 indicates mild nausea, 2 indicates severe nausea or a single episode of vomiting, and 3 indicates multiple episodes of vomiting. PONV scores will be recorded and compared between groups during the postoperative period. Higher scores indicate more severe postoperative nausea and vomiting and therefore worse clinical outcomes.

    Measured: First 24 hours after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 May 2026
  2. Study start15 Jun 2026 (estimated)
  3. Primary completion15 Oct 2026 (estimated)
  4. Study completion16 Oct 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants scheduled for elective modified radical mastectomy will be randomly assigned in a parallel-group design to receive either ultrasound-guided Serratus Posterior Superior Intercostal Plane (SPSIP) block or Serratus Anterior Plane (SAP) block prior to induction of general anesthesia. Randomization will be performed using a computer-generated allocation sequence. Both groups will receive standardized general anesthesia and postoperative multimodal analgesia protocols to minimize confounding variables. Postoperative pain scores, opioid consumption, rescue analgesic requirements, and perioperative adverse events will be compared between groups. Outcome assessments will be conducted at predefined postoperative time intervals by investigators blinded to group allocation whenever feasible. The study is designed to evaluate the comparative analgesic efficacy and safety profile of the two regional anesthesia techniques in breast surgery patients.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
70 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07601490
Sponsor's protocol ID
SBU-ANESTEZİ-DMY-05
Acronym
breast surgery
Status last verified
May 2026
First submitted
15 May 2026
Last updated
27 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Arik E, Zengin M, Seker G, Kucuk O, Gungordu E, Ozguner Y, Alagoz A, Ergil J. Is the serratus posterior superior intercostal plane block a viable alternative to the erector spinae plane block for postoperative analgesia in breast surgery? A prospective, randomized trial. BMC Anesthesiol. 2025 Nov 29;26(1):11. doi: 10.1186/s12871-025-03531-y.

    PubMed 41318393
  • Baytar C, Aktas B, Aydin BG, Piskin O, Cakmak GK, Ayoglu H. The effects of ultrasound-guided serratus anterior plane block on intraoperative opioid consumption and hemodynamic stability during breast surgery: A randomized controlled study. Medicine (Baltimore). 2022 Sep 2;101(35):e30290. doi: 10.1097/MD.0000000000030290.

    PubMed 36107549

Questions about this trial

What is this clinical trial studying?

A study testing Serratus Posterior Superior Intercostal Plane Block and Serratus anterior plane block (SAP) in people with Breast Cancer Surgery Pain, run by Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 27 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Dilek Metin Yamac, MD (+905054959792, ddilekmetin@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Postoperative pain intensity assessed by Visual Analog Scale (VAS) (time frame: At postoperative 1, 2, 4, 8, 12, and 24 hours after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07601490, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 May 2026.

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