Comparison of rhomboid intercostal nerve block, erector spinae plane
block, and serratus plane block on analgesia for modified radical
mastectomy: A prospective, randomized, controlled trial
Abstract
Background and objectives Breast cancer is one of the most common
malignant tumors in women. Herein, we compared the analgesic efficacy of
ultrasound-guided rhomboid intercostal nerve block , erector spinae
plane block and serratus plane block after modified radical mastectomy
of unilateral breast cancer. Methods: A total of 90 patients who
underwent modified radical mastectomy for unilateral breast cancer were
selected. patients were randomly allocated into three groups receiving
ultrasound-guided serratus plane block, erector spinae plane block, and
the rhomboid intercostal block group. All groups received 20 mL 0.5%
ropivacaine. Within 24 hours after operation, the patient received
intravenous injection of tramadol 1-2 mg/kg to relieve pain in the
surgical ward. Results: The dosage of tramadol 24-hours postoperatively
in the rhomboid intercostal block and erector spinae plane block groups
was significantly lower than that in serratus plane block group (P
< 0.001). There was no statistical difference in tramadol
consumption between the erector spinae plane block and rhomboid
intercostal block groups within 24 hours (P = 0.676). The numerical
rating scale scores in the erector spinae plane block and rhomboid
intercostal block groups at 0.5, 1, 3, 6, 12, 18, and 24 hours
postoperatively once patients were active were significantly lower than
in the serratus plane block group (P < 0.05 for all
comparisons); however, The numerical rating scale scores between
rhomboid intercostal block and erector spinae plane block groups did not
differ significatively within 24 hours after surgery when patients were
active. Conclusions: Ultrasound-guided rhomboid intercostal block and
erector spinae plane block can reduce the dosage of tramadol and NRS
score compared with serratus plane block after modified radical
mastectomy.