A Comparative Study of Erector Spinae Plane Block and Serratus Posterior Superior Intercostal Plane Block on Postoperative Opioid Consumption Following Breast and Axillary Dissection Surgery

"the ESP block will be administered after surgery but before the patient is awakened, under sterile conditions and ultrasound guidance.~Patient Positioning: The patient will be placed in the lateral position with the surgical side up, and a sterile ultrasound probe cover will be used.~Ultrasound Imaging: A high-frequency (11-12 MHz) linear probe will be placed transversely at the T5 thoracic vertebra.~Anatomy Identification: The erector spinae muscle and transverse processes will be visualized.~Needle Insertion: Using an in-plane technique, the needle will be advanced to the transverse process.~Injection: After confirming the needle position with 1-2 mL saline, 30 mL of 0.25% bupivacaine will be injected between the erector spinae muscle and transverse process, with spread monitored via ultrasound."

"In Group 3, SPSIP block will be administered after surgery but before the patient is awakened, under sterile conditions and ultrasound guidance.~Patient Positioning: The patient will be placed laterally with the surgical side up, using a sterile ultrasound probe cover.~Ultrasound Imaging: A high-frequency (11-12 MHz) linear probe will be positioned sagittally at the scapula's upper corner to visualize the rhomboid major, trapezius, serratus posterior superior muscles, and the third rib.~Anatomy Identification: The third rib and serratus posterior superior muscle will be identified.~Needle Insertion: Using an in-plane technique, the needle will be advanced between the serratus posterior superior muscle and the third rib.~Injection: After confirming the needle position with 1-2 mL saline, 30 mL of 0.25% bupivacaine will be injected into the space, with spread monitored via ultrasound."

0.25% bupivacaine