Two ultrasound-guided nerve blocks to reduce pain after mastectomy

A Comparative Study Between Ultrasound Guided Combined Rhomboid Intercostal and Sub- Serratus Plane Blocks and Erector Spinae Plane Block as Perioperative Analgesia in Mastectomy Surgeries in Cancer Breast Patients

This trial will try combined rhomboid intercostal/sub‑serratus and erector spinae ultrasound-guided nerve blocks to reduce pain after mastectomy in adult women with breast cancer.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 40 (estimated)
• Ages: 18 Years to 60 Years
• Sex: Female
• Sponsor: National Cancer Institute, Egypt (Academic / other)
• Drugs / interventions: chemotherapy, radiation
• Locations: 1 site (Cairo)
• Trial ID: NCT07390448 on ClinicalTrials.gov

What this trial studies

Adult women with breast cancer scheduled for elective mastectomy or breast‑conserving surgery with axillary dissection will receive ultrasound-guided combined rhomboid intercostal sub‑serratus plane blocks and erector spinae plane block as regional analgesia. Researchers will follow patients after surgery to record pain scores, opioid consumption, recovery metrics, and complications. The approach builds on existing regional anesthesia techniques and uses ultrasound to guide local anesthetic delivery to targeted chest wall and paraspinal planes. Outcomes will determine whether this combined block strategy improves immediate postoperative pain control and may reduce development of chronic post-mastectomy pain.

Who should consider this trial

Good fit: Adult female breast cancer patients ASA class II–III, aged 18–60 years with BMI 20–35 kg/m2 undergoing elective mastectomy or breast-conserving surgery with axillary dissection are the intended participants.

Not a fit: Patients with major medical conditions, who are pregnant or lactating, outside the age/BMI ranges, or who decline the blocks are excluded and unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, the blocks could reduce acute post-mastectomy pain, lower opioid needs, and shorten recovery with a lower risk of chronic pain.

How similar studies have performed: Other regional techniques (paravertebral, serratus plane, and pectoral nerve blocks) have shown good post-mastectomy pain relief, and early reports suggest erector spinae and rhomboid intercostal/sub‑serratus blocks may be effective though evidence is still emerging.

Eligibility criteria

Inclusion Criteria:

1. Breast cancer female patients.
2. ASA class II and III.
3. Age ≥ 18 and ≤ 60 Years.
4. Body mass index (BMI): \> 20 kg/m2 and \< 35 kg/m2.
5. Type of surgery; elective breast cancer surgery (either modified radical mastectomy or conservative breast surgery) combined with axillary dissection.

Exclusion Criteria:

1. Patient refusal.
2. Age \<18 years or \>65 years.
3. BMI \<20 kg/m2 and \>35 kg/m2.
4. Major medical conditions.
5. Pregnancy or lactation.

Where this trial is running

Cairo

• National Cancer Institute - Cairo University — Cairo, Egypt (Recruiting)

Study contacts

• Principal investigator: Ayman Sharawy Abdelrahman Aboul Nasr, MD — National Cancer Institute Cairo University
• Study coordinator: Ayman Sharawy Abdelrahman Aboul Nasr, MD

Conditions Breast Cancer; erector spinae plane block; Rhomboid Intercostal and Sub-serratus Plane Blocks; ultra sound