The Efficacy of Ultrasound-Guided Rhomboid Intercostal Block Versus Serratus Plane Block in Modified Radical Mastectomy

Modified radical mastectomy (MRM) is the traditional surgery for breast cancer (BC) management. Rhomboid intercostal block (RIB) is a novel fascial block approach. So, this study aimed to compare and evaluate analgesic efficacy of ultrasound (US)-guided RIB versus serratus plane block (SPB) in patients undergoing MRM using dexmedetomidine as an adjuvant to bupivacaine. This prospective randomised comparative study comprised 100 patients scheduled for MRM under general anesthesia (GA). They were divided into two groups; in the SPB group, 50 patients administered ipsilateral SPB with 30 mL of 0.25% bupivacaine and 10 mcg of dexmedetomidine at the 5th rib level. In the RIB group, 50 patients received an ipsilateral RIB with 30 mL of 0.25% bupivacaine and 10 mcg of dexmedetomidine. Postoperative pain (POP) was measured using the visual analogue scale (VAS) at various time points. Time for the 1st rescue analgesic request was prolonged in the RIB group. Total rescue analgesic consumption in the initial 24 postoperative hours was significantly decreased in the RIB group. VAS score was significantly higher in SPB group at 6 hours and 8 hours than the RIB group, while there were non-significant differences between both groups at other time intervals. Postoperative nausea and vomiting (PONV) were recorded in 3 cases of RIB group. So, both RIB and SAPB are efficient approaches for reducing postoperative pain for patients undergoing MRM. RIB group showed more effective and prolonged pain control during early postoperative period.