Indian journal of anaesthesia · 2026
Comparison of analgesic efficacy of erector spinae plane block with rhomboid intercostal subserratus plane block in patients undergoing modified radical mastectomy: A randomised control trial.
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Kumari Poonam, Ramesh Athira, Kumar Amarjeet, Jain Rahul, Sinha Chandni, Kumar Deepak
Аннотация
BACKGROUND AND AIMS: One of the most popular procedures for breast cancer is modified radical mastectomy (MRM), which is associated with severe postoperative pain. The rhomboid intercostal subserratus (RISS) plane block, a recently developed procedure, is used to treat postoperative pain after MRM. The aim of this study was to compare the analgesic effectiveness of RISS block with erector spinae plane (ESP) block in terms of 24-hour opioid consumption in patients following MRM.
METHODS: In this randomised control study, we enroled 40 American Society of Anesthesiologists (ASA) physical status I-II patients aged 18-65 years who were posted for MRM surgery. The patients were allocated into two groups: Group I: ESP block with 20 ml of 0.25% bupivacaine; Group II: RISS block with 40 ml of 0.25% bupivacaine. Total postoperative fentanyl consumption over 24 hours was the primary outcome. Intraoperative fentanyl requirement, first rescue analgesic administration time, numerical rating scale (NRS) score at 24 hours postoperatively at different time intervals, and patient satisfaction score were the secondary outcomes.
RESULTS: The fentanyl requirement in the 24 hours postoperatively for the ESP group was 79.50 ± 35.46 μg, compared to 80.50 ± 39.79 μg for the RISS group. No significant difference was found between the groups (P = 0.88). Similarly, intraoperative fentanyl requirement did not differ significantly (P = 0.11). The first rescue analgesia time did not show a statistically significant difference between the groups (P = 0.25). Additionally, there were no significant differences (P > 0.05) between the groups in the NRS scores measured at various time intervals.
CONCLUSION: The RISS block can be used as an alternative to the ESP block in patients scheduled for a MRM.
METHODS: In this randomised control study, we enroled 40 American Society of Anesthesiologists (ASA) physical status I-II patients aged 18-65 years who were posted for MRM surgery. The patients were allocated into two groups: Group I: ESP block with 20 ml of 0.25% bupivacaine; Group II: RISS block with 40 ml of 0.25% bupivacaine. Total postoperative fentanyl consumption over 24 hours was the primary outcome. Intraoperative fentanyl requirement, first rescue analgesic administration time, numerical rating scale (NRS) score at 24 hours postoperatively at different time intervals, and patient satisfaction score were the secondary outcomes.
RESULTS: The fentanyl requirement in the 24 hours postoperatively for the ESP group was 79.50 ± 35.46 μg, compared to 80.50 ± 39.79 μg for the RISS group. No significant difference was found between the groups (P = 0.88). Similarly, intraoperative fentanyl requirement did not differ significantly (P = 0.11). The first rescue analgesia time did not show a statistically significant difference between the groups (P = 0.25). Additionally, there were no significant differences (P > 0.05) between the groups in the NRS scores measured at various time intervals.
CONCLUSION: The RISS block can be used as an alternative to the ESP block in patients scheduled for a MRM.