Comparison of the effects of serratus anterior planeblock (SAPB) and rhomboid intercostal plane block (RİPB) on analgesia in patients who was applied breast cancersurgery

Objective: Breast cancer ranks first among the cancer types encountered in women. In parallel with this, breast cancer surgeries are also frequently performed interventions. In these operations, interfascial plane blocks, which are easy to apply and safe for postoperative analgesia, are becoming increasingly common. In our study, we purposed to compare the effects of serratus anterior plane block and rhomboid intercostal plane block on postoperative analgesia in patients who was applied breast cancer surgery. Materials and Methods: The study was performed in 40 patients aged between 18-70 years with ASA (American Society of Anesthesiologists) scores between I and III, who would undergo breast cancer surgery after obtaining written consent from the patients after ethics committee confirmation. The study was designed as double-blind, prospective, randomized. Anesthesia was induced in the same way for all patients and they were intubated. Patients were divided into SAPB (Group S) and RIPB (Group R). A local anesthetic mixture solution consisting of 20ml 0.25% bupivacaine, 10ml 0.5% lidocaine and 10ml saline was injected into both groups before postoperative extubation. Patient-controlled analgesia (PCA) was used in the postoperative period using intravenous morphine. Postoperative 20th minute, 40th minute, 1st hour, 3rd hour, 6th hour, 12th hour, 18th hour and 24th hour NRS (numerical pain score) scores and opioid consumption were recorded. The time to the first analgesia necessity was described as the time to analgesia and recorded. Simultaneously, complications (nausea/vomiting, pneumothorax, hematoma, pruritus) were also recorded. Results: When the serratus anterior plane block and rhomboid intercostal plane block performed with ultrasonography were compared, the NRS scores were statistically similar at all times postoperatively (p>0.05). The mean total morphine x consumption in 24 hours was 3.05mg in Group S and 1.75mg in Group R, and the median values of opioid consumption were not statistically dissimilar (p>0.05). When the patients were analyzed in terms of duration of analgesia, complications and need for rescue analgesics, no difference was found between the two groups (p>0.05). Conclusion: Consequently, we detect that the opioid consumption of serratus anterior plane block and rhomboid intercostal plane block in breast cancer surgery was similar. In order to provide postoperative analgesia in breast cancer surgery, both plane blocks can be preferred as a component of multimodal analgesia.