{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:05:01Z","timestamp":1781877901216,"version":"3.54.5"},"reference-count":26,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T00:00:00Z","timestamp":1624320000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2021,5,28]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Paravertebral and serratus plane blocks are both used to treat pain following breast surgery. However, it remains unknown if the newer serratus block provides comparable analgesia to the decades-old paravertebral technique.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Subjects undergoing unilateral or bilateral non-mastectomy breast surgery were randomized to a single-injection serratus or paravertebral block in a subject-masked fashion (ropivacaine 0.5%; 20 mL unilateral; 16 mL\/side bilateral). We hypothesized that (1) analgesia would be non-inferior in the recovery room with serratus blocks (measurement: Numeric Rating Scale), and (2) opioid consumption would be non-inferior with serratus blocks in the operating and recovery rooms. In order to claim that serratus blocks are non-inferior to paravertebral blocks, both hypotheses must be at least non-inferior.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Within the recovery room, pain scores for participants with serratus blocks (n=49) had a median (IQR) of 4.0 (0\u20135.5) vs 0 (0\u20133.0) for those with paravertebral blocks (n=51): 0.95% CI \u22123.00 to \u22120.00; p=0.001. However, the difference in morphine equivalents did not reach statistical significance for superiority with the serratus group consuming 14 mg (10\u201319) vs 10 mg (10\u201316) for the paravertebral group: 95% CI \u22124.50 to 0.00, p=0.123. Since the 95% CI lower limit of \u22124.5 was less than our prespecified margin of \u22122.0, we failed to conclude non-inferiority of the serratus block with regard to opioid consumption.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Serratus blocks provided inferior analgesia compared with paravertebral blocks. Without a dramatic improvement in safety profile for serratus blocks, it appears that paravertebral blocks are superior to serratus blocks for postoperative analgesia after non-mastectomy breast surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03860974\">NCT03860974<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2021-102785","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T11:53:53Z","timestamp":1624362833000},"page":"773-778","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Serratus anterior plane versus paravertebral nerve blocks for postoperative analgesia after non-mastectomy breast surgery: a randomized controlled non-inferiority trial"],"prefix":"10.1136","volume":"46","clinical-trial-number":[{"clinical-trial-number":"nct03860974","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Rodney A","family":"Gabriel","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia, University of California San Diego, La Jolla, California, USA"},{"name":"Department of Medicine, Division of Biomedical Informatics, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W","family":"Swisher","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacklynn F","family":"Sztain","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian P","family":"Curran","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7897-1670","authenticated-orcid":false,"given":"Engy T","family":"Said","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy B","family":"Abramson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahareh","family":"Khatibi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3657-0673","authenticated-orcid":false,"given":"Brenton S","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J","family":"Finneran","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava","family":"Armani","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Blair","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Dobke","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Suliman","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Reid","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C","family":"Donohue","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian M","family":"Ilfeld","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia, University of California San Diego, La Jolla, California, 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