• Kok Wang Tan, Syarifah Noor Nazihah Sayed Masri, Qurratu Aini Musthafa, Azrin Mohd Azidin, Amiruddin Nik Mohamed Kamil, Azarinah Izaham, and Md NorNadiaNDepartment of Anaesthesiology & Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia..
• Department of Anaesthesiology & Intensive Care, Hospital Tuanku Jaafar Seremban, Negeri Sembilan, Malaysia.
• Medicine (Baltimore). 2022 Sep 2; 101 (35): e30515e30515.

BackgroundThe serratus plane block is an effective technique for providing analgesia to patients undergoing breast surgery.MethodsThis prospective, double-blind, randomized study enrolled 60 female patients scheduled for unilateral mastectomy and axillary clearance. The patients received either a superficial serratus plane block or deep serratus plane block. Dermatomal spread was recorded 30 minutes after block administration. Postoperatively, pain visual analog scale (VAS) scores were documented at recovery (time 0), at 30 minutes; and in the ward hourly for 4 hours, and 4-hourly until 24 hours postoperatively. The time to first analgesic rescue and cumulative morphine consumption using patient-controlled analgesia morphine (PCAM) were recorded.ResultsThe results showed lower VAS scores at rest (at 1, 2, 3, and 4 hours postoperatively), and during movement (at 1, 2, 3, 4, 8, and 24 hours postoperatively) in the superficial serratus plane block group, P < .005. Similarly, cumulative morphine usage was lower in the superficial serratus plane group, P < .005. The time to the first rescue analgesic was also significantly longer in the superficial group, P < .001. More patients in the superficial serratus plane group achieved greater dermatomal spread at T2 and T7 than those in the deep group.ConclusionsSuperficial serratus plane block provides better analgesic efficacy than deep serratus plane block in mastectomy and axillary clearance.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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