Effect of ultrasound-guided superficial versus deep serratus anterior plane block on postoperative analgesia in modified radical mastectomy for breast cancer
Wan Lun
Li Chenglong
Huang Lisha
Zhan Yucheng
Long Shiying
Wang Zheng
Zong Chujun
Chen Weijian
Abstract：Objective To compare the postoperative analgesic efficacy of ultrasound-guided superficial versus deep serratus anterior plane block(SAPB)in patients undergoing modified radical mastectomy(MRM)for breast cancer,providing evi-dence for clinical decision-making.Methods Sixty-six MRM patients at Guangdong Second Traditional Chinese Medicine Hospital(June-November 2024)were randomized into three groups:control(Group C,n=22),superficial SAPB(Group S,n=22),and deep SAPB(Group D,n=22).Group C received laryngeal mask general anesthesia alone;Group S received laryngeal mask general anesthesia combined with superficial SAPB;Group D received laryngeal mask general anesthesia combined with deep SAPB.Visual Analog Scale(VAS)scores at 3,6,12,and 24 hours postoperatively,tramadol con-sumption and postoperative nausea/vomiting(PONV)incidence within 24 hours,and 40-item Quality of Recovery scale(QoR-40)scores at 24 hours were compared.Results VAS scores differed significantly among groups at all time points(P<0.05).Groups S and D exhibited significantly lower VAS scores than Group C(P<0.05),with Group D further re-ducing scores compared to Group S at 12 hours(P<0.05).Significant differences were noted in time to first tramadol use among the three groups(P<0.05);time to first tramadol use was significantly shorter in Group C than in Groups S and D(P<0.05).Tramadol usage rate and PONV incidence were significantly higher in Group C than in Groups S and D(P<0.05).SAPB procedure time in Group D was significantly shorter than that in Group S[(2.9±1.7)min vs.(8.0±2.7)min,P<0.05].QoR-40 subdomains(physical comfort,emotional state,self-care ability,psychological support,pain)were significantly higher in Groups S and D than in Group C(P<0.05).Conclusion Deep SAPB provides superior early postoperative analgesia and faster procedural efficiency for MRM,making it the preferred regional analgesic technique.Se-lection between SAPB approaches should be individualized based on patient anatomy and surgical factors within a multimodal analgesia framework for pain management.
Keywords：Superficial serratus anterior plane blockDeep serratus anterior plane blockBreast cancer surgeryPostoperative analgesiaUltrasound-guided
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 113-118 )