Is there a difference in the postoperative quality of recovery and analgesia between erector spinae and serratus anterior plane blocks following modified radical mastectomy: a randomized controlled study

The postoperative recovery quality of patients may be associated with the efficacy of perioperative analgesia management. The effects of erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) on the quality of recovery following breast cancer surgery have not been clearly established. The objective of the present study is to assess the quality of recovery and analgesic efficiency of ESPB and SAPB as postoperative analgesia methods in modified radical mastectomy surgeries. A total of 68 female patients undergoing modified radical mastectomy were randomly separated into two groups. The main outcome of this randomized, double-blind prospective study was the 40-item global quality of recovery (QoR-40) questionnaire score, collected at 24 and 48 h postoperatively. Other measures of interest included postoperative numerical rating scale (NRS), cumulative opioid consumption, time to first analgesic request, demographic data, hemodynamic variables and postoperative complications such as nausea, vomiting and dizziness. In the postoperative period after 24 h, the global QoR-40 scores were found as 185.5 (range:150–199) in the ESPB group and 186 (range:158–198) in the SAPB group (p = 0.304). The median time to first analgesic request was 645 min (range:30–740) in the ESPB group and 640 min (range:30–700) in the SAPB group, without any statistical variation between the groups (p = 0.216). Cumulative opioid consumption did not significantly differ between the two groups (p = 0.785). Likewise, no significant difference was detected between the ESPB and SAPB groups in mean arterial pressure, heart rate, SpO₂ levels or complication rates. Preoperative administration of ESPB and SAPB in breast cancer surgery improved the quality of recovery and effectively reduced analgesic requirement. Future studies should investigate how local anesthetic type and volume affect postoperative recovery and analgesia. ClinicalTrials.gov ID: NCT04296188 on 03/03/2020.