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Effect of Serratus and Pectoralis II Plane Block Versus Pectoralis II Alone on Acute Postoperative Pain After Mastectomy
Sponsor: Lebanese American University
Summary
The goal of this randomized controlled clinical trial is to determine whether adding a serratus anterior plane block (SAPB) to a pectoralis II (PECS II) block improves pain relief and reduces the need for opioids in adult women undergoing breast removal surgery (mastectomy), with or without removal of lymph nodes from the armpit. The main questions it aims to answer are: 1. Does adding an SAPB to a PECS II block reduce the total amount of opioids needed in the recovery room and during the first 24 hours after surgery? 2. Does the combination reduce the amount of opioid pain medication needed during surgery? 3. Does the combination improve pain levels during the first 24 hours after surgery? 4. Does the combination affect the occurrence of side effects or complications, including nausea, vomiting, drowsiness, serious reactions to the local anesthetic, and collapsed lung? Researchers will compare a group receiving both SAPB and PECS II blocks with a group receiving only a PECS II block to determine whether the combination improves pain relief and reduces opioid requirements. Participants will: 1. Be randomly assigned to one of two groups, with both groups receiving general anesthesia for surgery. 2. Receive the assigned nerve block or blocks using ultrasound guidance and a local anesthetic medicine called ropivacaine. 3. Receive postoperative pain relief through a patient-controlled analgesia (PCA) device, which allows them to administer prescribed doses of morphine when needed, in addition to other pain medications. 4. Have their opioid use and pain levels assessed at scheduled intervals during the first 24 hours after surgery. 5. Be monitored for additional pain medication requirements, side effects, block-related complications, and changes in heart rate and blood pressure during surgery.
Official title: Effect of Combination of Serratus and Pectoralis II Plane Block Versus Pectoralis II Plane Block Alone on Acute Postoperative Pain After Mastectomy
Key Details
Gender
FEMALE
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
80
Start Date
2026-12
Completion Date
2029-03
Last Updated
2026-10-19
Healthy Volunteers
No
Conditions
Interventions
Serratus Anterior Plane Block (SAPB) group
An experienced anesthesiologist will perform a single deep serratus anterior plane block before induction of general anesthesia under ultrasound guidance and aseptic conditions, injecting 15-20 mL of ropivacaine 0.375%, adjusted according to body weight, into the plane deep to the serratus anterior muscle. The total ropivacaine dose across both blocks will not exceed 3 mg/kg.
Pectoral nerve block (PECS)
An experienced anesthesiologist will perform a single PECS II block before induction of general anesthesia under ultrasound guidance and aseptic conditions, injecting a total of 20 mL of ropivacaine 0.375% into the appropriate interfascial planes.
Locations (1)
Lebanese American University Medical Center-Rizk Hospital
Beirut, Lebanon