Gökhan Aslan1, Onur Avcı1, Oğuz Gündoğdu2, Ahmet Cemil İsbir1, İclal Özdemir Kol1, Kenan Kaygusuz1, Sinan Gürsoy1

1Department of Anesthesiology and Reanimation, Cumhuriyet University School of Medicine, Sivas, Turkey
2Clinic of Anesthesiology and Reanimation, Numune Hospital, Sivas, Turkey


Objective: This study aimed to evaluate the effect of serratus anterior plane block (SAP) on postoperative morphine consumption. We aimed to determine the differences between both similar blocks and evaluate the effect of the methods of application of this block on patients’ postoperative pain scores and morphine consumption.

Material and Methods: This study is a single-center, prospective and observational study performed with 40 volunteer patients with American Society of Anesthesiologists (ASA) I-III, who were 18-70 years of age, scheduled for breast surgery. A total of 40 patients who underwent general anesthesia were divided into two groups each with 20 patients. While SAP block was applied to the study group, no block was applied to the control group. SAP block was made by injecting a total of 40 ml of 0.25% bupivacaine between 2 muscles after the test dose was injected with saline. All patients were followed up for 12 hours postoperatively with patient-controlled analgesia (PCA) pump. Morphine consumption, visual analogue score (VAS) values and side effects were recorded at the postoperative 1st, 6th and 12th hours.

Results: There was no significant difference between the two groups in terms of hemodynamic parameters and demographic data. Postoperative morphine consumption and postoperative analgesic requirement were significantly lower in the SAP block group (p< 0.001). Postoperative VAS values were significantly lower in the SAP block group (p< 0.001). No complication was observed related to the block.

Conclusion: It was found that the SAP block reduced morphine consumption, significantly decreased VAS values, and reduced side effects due to opioids postoperatively.

Keywords: Serratus anterior plane block, breast surgery, postoperative pain management

Cite this article as: Aslan G, Avcı O, Gündoğdu O, İsbir AC, Özdemir Kol İ, Kaygusuz K, et al. The effect of postoperative serratus anterior plane block on postoperative analgesia in patients undergoing breast surgery. Turk J Surg 2020; 36 (4): 374-381.


Ethics Committee Approval

The approval for this study was obtained from Cumhuriyet University Clinical Research Ethics Committee (Decision No: 2019-03/03, Date: 19.03.2019).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept - G.A., O.A., O.G.; Design - A.C.İ., İ.Ö.K., K.K., S.G.; Supervision - G.A., O.A., O.G.; Resource - A.C.İ., İ.Ö.K., K.K., S.G.; Materials - G.A., O.A., O.G.; Data Collection and/or Processing - A.C.İ., İ.Ö.K., K.K., S.G.; Analysis and Interpretation - G.A., O.A., O.G.; Literature Review - G.A., O.A., O.G.; Writing Manuscript - A.C.İ., İ.Ö.K., K.K., S.G.; Critical Reviews - G.A., O.A., O.G.

Conflict of Interest

The authors declare that they have no conflict of interest.

Financial Disclosure

The authors declared that this study has received no financial support.


We thank to all the members of anesthesiology and general surgery departments and also special thanks to Selim Çam for his helps about statistical analyses.