Paravertebral or Serratus Anterior Plane Block Combined with Interpectoral Blocks versus Paravertebral Block for Mastectomy: A Cluster-randomized Trial of 1,507 Patients
Primary result · High postoperative opioid useResult — go to the resultDifference (lower rate) 1.9 % 95% CI −2.7% to 6.5%Authors' conclusion
Paravertebral or serratus anterior plane blocks combined with PECS I blocks were not superior to paravertebral block alone in reducing high opioid use after bilateral mastectomy with expander reconstruction.
Study context
- Population
- Patients undergoing bilateral mastectomy with immediate expander reconstructionrandomised 2019–2023
- Participants
- 1,507 patients
- Comparison
- Paravertebral + PECS I or serratus anterior plane + PECS I blocks vs paravertebral block alone
- Paravertebraln = 492reference
- Paravertebral plus PECS In = 446
- Serratus anterior plane plus PECS In = 568
- Primary endpoint
- Postoperative opioid consumption (rate of high postoperative opioid use)
Methodological detailssingle-centre, cluster-randomised by month, clinically integrated
- Single-centre
- Cluster-randomised by month
- Clinically integrated
Primary result
High postoperative opioid use
Difference (lower rate)
1.9 %
95% CI −2.7% to 6.5%
P = 0.4
By group
As reported in the abstract
Secondary outcomes
Secondary outcomes (pain scores, antiemetic use, discharge time, adverse events, chronic pain, quality of recovery)
- No significant differences for any secondary outcomes when accounting for multiple testing
Original publication
Paravertebral or Serratus Anterior Plane Block Combined with Interpectoral Blocks versus Paravertebral Block for Mastectomy: A Cluster-randomized Trial of 1,507 Patients. Anesthesiology. Published 10 November 2025. doi:10.
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