Preservation Breast Augmentation Under Sedation Is a Low-Pain Procedure: A Randomized Controlled Trial of Serratus Anterior Plane Block as an Adjunct
In brief
Serratus plane block halves intra-operative fentanyl and cuts propofol use by 20%
In a randomized trial of 40 women undergoing preservation breast augmentation with local anesthesia and sedation, a pre-operative deep serratus anterior plane block reduced rescue propofol by about 10 mg (≈20%) and fentanyl by roughly 10 µg (≈50%). Early postoperative pain scores were modestly lower, though overall pain remained low for all patients. The block offers a selective analgesic benefit without added complications.
- Journal
- Aesthetic surgery journal (Q1)
- Published
- 5 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Burak Ergün Tatar, Ezgi Polat, Emirhan Kahraman, Ferhat Şimşek, Mehmet Aydın, Burak Özkan
- PMID
- 42700371
- DOI
- 10.1093/asj/sjag188
Why clinicians should know about it
- Picked for Anesthesiology and Pain Medicine (paper of the day, 7 September 2026): RCT of serratus anterior plane block for breast augmentation
Abstract
BACKGROUND: Preservation breast augmentation (PBA) is an intralamellar technique preserving the pectoralis major muscle, circummammary ligament, and Cooper's suspensory ligaments. Its perioperative pain profile and the value of regional anesthesia adjuncts remain uncharacterized. OBJECTIVES: To characterize the perioperative pain profile of PBA under local anesthesia and sedation, and to determine whether a preoperative deep SAP block reduces intraoperative analgesic requirements and early postoperative pain. METHODS: This prospective, randomized, single-blind trial enrolled 40 women undergoing PBA. Patients were randomized 1:1 to a preoperative deep SAP block (20 mL of 0.25% bupivacaine bilaterally) or standard care; all procedures used tumescent local anesthesia and propofol sedation. Endpoints included 24-hour NRS score, rescue propofol and fentanyl consumption, hemodynamic response, and postoperative analgesic use. RESULTS: Baseline characteristics were comparable. The SAP group required less rescue propofol (45 ± 3 vs. 55 ± 4 mg; p < 0.001; d = 2.83) and fentanyl (12 ± 5 vs. 22 ± 9 µg; p < 0.001; d = 1.37). NRS scores favored the SAP group at 60 min (3.4 vs. 4.5; p = 0.011) and 6 h (3.8 vs. 4.7; p = 0.035), converging by 24 h (3.4 vs. 3.2; p = 0.377); both groups remained within a low pain range (NRS ≤ 3.5). No major complications occurred. CONCLUSIONS: PBA under local anesthesia and sedation is associated with a consistently low perioperative pain profile. The SAP block provides a clinically meaningful intraoperative analgesic advantage and improves early postoperative comfort, supporting selective rather than routine use.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.