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Pectoralis-serratus interfascial plane block vs
thoracic paravertebral block for unilateral radical
mastectomy with axillary evacuation☆,☆☆

Research Authors
Diab Fuad Hetta MD (Lecturer)a,⁎,1,2,3, Khalid Mohammed Rezk MD (Lecturer)b,3,4,5
Research Member
Research Year
2016
Research Journal
Journal of Clinical Anesthesia
Research Publisher
NULL
Research Vol
Vol. 34
Research Rank
1
Research_Pages
pp. 91–97
Research Website
NULL
Research Abstract

Study Objective: The aim of this study was to evaluate the analgesic efficacy and safety of pectoralisserratus
interfascial plane block in comparison with thoracic paravertebral block for postmastectomy pain.
Design: A prospective randomized controlled study.
Setting: Tertiary center, university hospital.
Patients: Sixty-four adult women, American Society of Anesthesiologists physical status classes I, II, and
III, scheduled for unilateral modified radical mastectomy with axillary evacuation.
Interventions: Patients were randomized to receive either pectoralis-serratus interfascial plane block, PS
group (n = 32), or thoracic paravertebral block, PV group (n = 32).
Measurements: Twenty-four-hour morphine consumption and the time to rescue analgesic were recorded.
The pain intensity evaluated by visual analog scale (VAS) score at 0, 2, 4, 8, 16, and 24 hours postoperatively
was also recorded.
Main Results: The median (interquartile range) postoperative 24-hour morphine consumption was significantly
increased in PS group in comparison to PV group (PS vs PV), 20 mg (16-23 mg) vs 12 mg (10-14
mg) (P b .001). The median postoperative time to first analgesic request was significantly shorter in PS
group compared to PV group (PS, 6 hours [5-7 hours], vs PV, 11 hours [9-13 hours]) (P b .001). The intensity
of pain was low in both groups inVAS 0, 2, and 4 hours postoperatively. However, therewas significant
reduction in VAS in PV group compared to PS group at 8, 16, and 24 hours postoperatively.
Conclusions: Pectoralis-serratus interfascial plane block was safe and easy to perform and decreased intensity
of postmastectomy pain, but it was inferior to thoracic paravertebral block.
© 2016 Elsevier Inc. All rights reserved.