Comparison of serratus plane and erector spinae plane blocks for postoperative analgesia in unilateral breast surgery

The use of interfascial plane blocks for postoperative analgesia is becoming more widespread because they are easier to perform and have fewer complications. This prospective, single-blind, randomized controlled study compares the efficacy of serratus plane block (SPB) and erector spinae plane block (ESPB) for postoperative analgesia in patients undergoing unilateral breast surgery.

Seventy-four ASA I-II patients aged 18-65 years who underwent elective unilateral breast surgery were included in the study. After exclusion, 70 patients were randomized to receive SPB (n=35) or ESPB (n=35). In both groups, nerve blocks were administered under ultrasound guidance with 25ml of 0.25% bupivacaine. Postoperative pain (assessed using the visual analogue scale [EVA]), duration of analgesia, tramadol consumption, and incidence of complications were recorded.

There were no significant differences in EVA scores between groups. However, duration of analgesia was significantly higher in the ESPB group (395.6±141.9min) vs the SPB group (290.3±148.3min) (p=0.003). Total tramadol consumption over 24h was similar between groups: 70.9±48.6mg in the SPB group and 70.3±50.5mg in the ESPB group. Minimal postoperative complications, including nausea and vomiting, were noted with no significant difference between groups.

Both SPB and ESPB were safe and provided similar postoperative analgesia in patients undergoing unilateral breast surgery. ESPB provides longer lasting analgesia, and therefore improves patient comfort in the early postoperative period.