Comparison of Serratus Posterior Superior Intercostal Plane Block and Pectoral Nerve Block II for Postoperative Analgesia Following Modified Radical Mastectomy: A Retrospective Cohort Study
4 affiliations
- 1Department of Anesthesiology and Reanimation, İzmir City Hospital, 35540 Izmir, Türkiye
- 2Department of Anesthesiology and Reanimation, İzmir Faculty of Medicine, University of Health Sciences, 35540 Izmir, Türkiye
- 3Department of Anesthesiology and Reanimation, Izmir Bazekol Çiğli Hospital, 35630 Izmir, Türkiye
- 4Department of General Surgery, İzmir Faculty of Medicine, University of Health Sciences, 35540 Izmir, Türkiye
Abstract
Background/Objectives: To compare the postoperative analgesic efficacy of the serratus posterior superior intercostal plane (SPSIP) block and pectoral nerve block II (PECS II) in patients undergoing unilateral modified radical mastectomy (MRM). Methods: This single-center retrospective cohort study included 100 patients who underwent unilateral MRM and received either an SPSIP block (n = 34) or a PECS II block (n = 66). The primary outcome was the time from extubation to the first administration of rescue analgesia. Secondary outcomes included Numeric Rating Scale (NRS) pain scores at 1, 4, 8, and 12 h postoperatively, the maximum NRS pain score, and cumulative opioid consumption within the first 24 postoperative hours. The primary outcome was analyzed using a generalized linear model with a gamma distribution and log-link function adjusted for operative duration. A sensitivity analysis additionally adjusted for age, body mass index, American Society of Anesthesiologists (ASA) physical status, and smoking status. Results: Among 100 patients (SPSIP, n = 34; PECS II, n = 66), operative duration was longer in the PECS II group (p < 0.001). Time to first rescue analgesia was longer with SPSIP (7.5 [5.0–8.8] vs. 5.0 [3.0–8.0] h; p = 0.004), but the difference was not significant after adjustment for operative duration (exp(B) = 1.21, 95% CI 0.98–1.49; p = 0.077) or additional covariates (exp(B) = 1.17, 95% CI 0.94–1.46; p = 0.153). NRS scores were lower with SPSIP at 1 h (p < 0.001) and with PECS II at 8 and 12 h (Holm-adjusted p = 0.013 and p < 0.001). Twenty-four-hour tramadol consumption was similar (p = 0.922). No block-related complications were documented. Conclusions: After adjustment for operative duration, the longer time to first rescue analgesia observed in the SPSIP group did not retain statistical significance, and a similar result was obtained in the sensitivity analysis. The findings should be interpreted cautiously in view of the retrospective design and limited sample size.
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BibTeX
@article{basaran2026comparison,
title = {{Comparison of Serratus Posterior Superior Intercostal Plane Block and Pectoral Nerve Block II for Postoperative Analgesia Following Modified Radical Mastectomy: A Retrospective Cohort Study}},
author = {Hilal Hande Başaran and Canan Salman Önemli and Derya Arslan Yurtlu and Pelin Uzun Sarıtaş and Zeki Tuncel Tekgül and Cem Karaali},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218757},
url = {https://www.mdpi.com/2077-0383/15/21/8757},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comparison of Serratus Posterior Superior Intercostal Plane Block and Pectoral Nerve Block II for Postoperative Analgesia Following Modified Radical Mastectomy: A Retrospective Cohort Study
AU - Hilal Hande Başaran
AU - Canan Salman Önemli
AU - Derya Arslan Yurtlu
AU - Pelin Uzun Sarıtaş
AU - Zeki Tuncel Tekgül
AU - Cem Karaali
PY - 2026
DA - 2026/11/09
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218757
UR - https://www.mdpi.com/2077-0383/15/21/8757
AB - Background/Objectives: To compare the postoperative analgesic efficacy of the serratus posterior superior intercostal plane (SPSIP) block and pectoral nerve block II (PECS II) in patients undergoing unilateral modified radical mastectomy (MRM). Methods: This single-center retrospective cohort study included 100 patients who underwent unilateral MRM and received either an SPSIP block (n = 34) or a PECS II block (n = 66). The primary outcome was the time from extubation to the first administration of rescue analgesia. Secondary outcomes included Numeric Rating Scale (NRS) pain scores at 1, 4, 8, and 12 h postoperatively, the maximum NRS pain score, and cumulative opioid consumption within the first 24 postoperative hours. The primary outcome was analyzed using a generalized linear model with a gamma distribution and log-link function adjusted for operative duration. A sensitivity analysis additionally adjusted for age, body mass index, American Society of Anesthesiologists (ASA) physical status, and smoking status. Results: Among 100 patients (SPSIP, n = 34; PECS II, n = 66), operative duration was longer in the PECS II group (p < 0.001). Time to first rescue analgesia was longer with SPSIP (7.5 [5.0–8.8] vs. 5.0 [3.0–8.0] h; p = 0.004), but the difference was not significant after adjustment for operative duration (exp(B) = 1.21, 95% CI 0.98–1.49; p = 0.077) or additional covariates (exp(B) = 1.17, 95% CI 0.94–1.46; p = 0.153). NRS scores were lower with SPSIP at 1 h (p < 0.001) and with PECS II at 8 and 12 h (Holm-adjusted p = 0.013 and p < 0.001). Twenty-four-hour tramadol consumption was similar (p = 0.922). No block-related complications were documented. Conclusions: After adjustment for operative duration, the longer time to first rescue analgesia observed in the SPSIP group did not retain statistical significance, and a similar result was obtained in the sensitivity analysis. The findings should be interpreted cautiously in view of the retrospective design and limited sample size.
SN - 2077-0383
ER -