Comparative role of serratus anterior plane block and thoracic erector spinae plane block in post-operative analgesia for breast surgery.

Abstract

Objective: To compare the analgesic efficacy of the serratus anterior plane block and thoracic erector spinae plane block in terms of duration of analgesia, pain score at 12 hours, and total opioid consumption in women undergoing breast surgery. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesiology, Fauji Foundation Hospital, Islamabad. Period: Sep-2025 to Dec- 2025. Methods: Sixty female patients planned for unilateral breast surgery were included and equally randomized to receive either erector spinae plane block (Group ES) or serratus anterior plane block (Group SA). Severity of pain in the postoperative period was assessed using the Numerical Rating Scale. Primary outcome was the duration of analgesia (time to need for first rescue analgesia), while secondary outcomes included pain score at 12 hours and total opioid consumption in first 24 hours. Results: The duration of analgesia was significantly longer in Group ES compared to Group SA (394.3 ± 34.1 min vs. 324.3 ± 29.9 min, p < 0.0001). A lower but statistically non-significant pain score was observed at 12 hours in Group ES (4.43 ± 1.14 vs. 4.96 ± 1.03, p = 0.06). Similarly, total 24-hour opioid consumption was also lower in Group ES compared to Group SA, however it did not reach statistical significance (60.13 ± 11.86 mg vs. 64.23 ± 9.51 mg, p = 0.16). Conclusion: Erector spinae plane block provided a significantly longer duration of analgesia as compared to serratus anterior plane block in women undergoing breast surgery.