• Dina H Alhassanin, Amr A Elbadry, Hoda A Ezz, and Naglaa K Mohamed.
• Department of Anesthesia, Surgical Intensive Care, and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
• Minerva Anestesiol. 2024 Nov 26.

BackgroundThis research aimed to assess the analgesic efficacy of ultrasound-guided rhomboid intercostal block (RIB) or serratus plane block (SPB) versus IV opioid among modified radical mastectomy (MRM) patients.MethodsOne hundred and five female patients aged 18-65 years with American Society of Anesthesiologists (ASA) physical status II-III scheduled for unilateral MRM were randomly allocated into three equal groups: 1) control group (received IV basal analgesia); 2) SPB group (received ipsilateral SPB); and 3) RIB group (received ipsilateral RIB).ResultsVisual Analogue Scale (VAS) was significantly increased in control group compared to SPB group at Post-Anesthesia Care Unit (PACU) (1 [1-2], 0 [0-1]), 2 h (4 [3-4], 0 [0-1]), and 4 h (3 [3-4], 2 [1-2]) postoperative in control and SPB groups, respectively; and in comparison with RIB group at PACU (0 [0-1]), 2 h (1 [0-1]), 4 h, (1 [1-2]), 6 h (1 [1-2]), and 8 h (2 [1-2]), postoperative. VAS was significantly increased in SPB group at 6 h (4 [3-4]), and 8 h (4 [3.25-4]), compared to RIB group with P<0.0001. Time of first analgesic requirement (minutes) was significantly delayed in RIB (720 [480-720]) and SPB (360 [360-360]) groups in comparison with control group (60 [60-120]) and in RIB group in comparison with SPB group. The total postoperative 24 h morphine consumption (mg) was significantly increased in control group (15.69±1.64) when compared to SPB (9.6±1.42) and RIB (6.51±1.36) groups and in SPB group when compared to RIB group.ConclusionsBoth rhomboid intercostal and serratus anterior plane blocks were efficient for analgesia after modified radical mastectomy. However, RIB had better analgesic efficacy compared to SPB.

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