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RISS vs ESP Block for Postoperative Analgesia After Mastectomy
Sponsor: Bursa City Hospital
Summary
Breast cancer is one of the most common malignancies and represents an important public health problem. Modified radical mastectomy (MRM) is frequently associated with acute postoperative pain resulting from a combination of somatic and neuropathic mechanisms. Inadequately controlled postoperative pain may impair recovery, delay mobilization, increase opioid consumption, and negatively affect patient satisfaction and quality of life. Therefore, effective multimodal analgesia is an important component of perioperative care in patients undergoing breast surgery. Ultrasound-guided regional anesthesia techniques have gained increasing attention because they can provide effective postoperative analgesia while reducing opioid requirements and opioid-related adverse effects. The erector spinae plane block (ESPB) and rhomboid intercostal and subserratus plane (RISS) block are ultrasound-guided fascial plane techniques that may provide analgesia for thoracic and breast surgery. The aim of this randomized controlled study is to compare the postoperative analgesic efficacy of ultrasound-guided ESPB and RISS block in patients undergoing modified radical mastectomy and sentinel lymph node excision. The primary objective is to compare postoperative opioid consumption between the two techniques. Secondary outcomes include postoperative pain scores, analgesic requirements, and patient satisfaction. The hypothesis of the study is that ESPB and RISS block are comparable in terms of postoperative analgesic efficacy and that neither technique is superior to the other.
Official title: Comparison of the Postoperative Analgesic Efficacy of Ultrasound-Guided Rhomboid Intercostal and Subserratus Plane Block Versus Erector Spinae Plane Block in Modified Radical Mastectomy Surgery
Key Details
Gender
All
Age Range
18 Years - 80 Years
Study Type
INTERVENTIONAL
Enrollment
86
Start Date
2026-01-01
Completion Date
2026-09-01
Last Updated
2026-09-15
Healthy Volunteers
No
Conditions
Interventions
Erector Spinae Plane Block
Participants randomized to the ESPB group will receive an ultrasound-guided erector spinae plane block (ESPB) at the T5 vertebral level bilaterally. The block will be performed in the operating room after completion of surgery and before emergence from general anesthesia. Under ultrasound guidance, the erector spinae muscle and transverse process will be identified, and 30 mL of 0.25% bupivacaine will be injected into the erector spinae plane. Participants will subsequently receive standardized multimodal postoperative analgesia according to the study protocol.
Rhomboid Intercostal and Sub-Serratus block
Participants randomized to the RISS group will receive an ultrasound-guided rhomboid intercostal and subserratus plane (RISS) block bilaterally. The block will be performed in the operating room after completion of surgery and before emergence from general anesthesia. Under ultrasound guidance, 30 mL of 0.25% bupivacaine will be administered according to the RISS block technique. Participants will subsequently receive standardized multimodal postoperative analgesia according to the study protocol.
Locations (1)
Bursa City Hospital
Bursa, nilüfer, Turkey (Türkiye)