{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:33:42Z","timestamp":1786739622803,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>One of the most popular procedures for breast cancer is modified radical mastectomy (MRM), which is associated with severe postoperative pain. The rhomboid intercostal subserratus (RISS) plane block, a recently developed procedure, is used to treat postoperative pain after MRM. The aim of this study was to compare the analgesic effectiveness of RISS block with erector spinae plane (ESP) block in terms of 24-hour opioid consumption in patients following MRM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this randomised control study, we enroled 40 American Society of Anesthesiologists (ASA) physical status I-II patients aged 18-65 years who were posted for MRM surgery. The patients were allocated into two groups: Group I: ESP block with 20 ml of 0.25% bupivacaine; Group II: RISS block with 40 ml of 0.25% bupivacaine. Total postoperative fentanyl consumption over 24 hours was the primary outcome. Intraoperative fentanyl requirement, first rescue analgesic administration time, numerical rating scale (NRS) score at 24 hours postoperatively at different time intervals, and patient satisfaction score were the secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The fentanyl requirement in the 24 hours postoperatively for the ESP group was 79.50 \u00b1 35.46 \u03bcg, compared to 80.50 \u00b1 39.79 \u03bcg for the RISS group. No significant difference was found between the groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.88). Similarly, intraoperative fentanyl requirement did not differ significantly (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.11). The first rescue analgesia time did not show a statistically significant difference between the groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.25). Additionally, there were no significant differences (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05) between the groups in the NRS scores measured at various time intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The RISS block can be used as an alternative to the ESP block in patients scheduled for a MRM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_1582_25","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T16:00:40Z","timestamp":1779292840000},"page":"669-675","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of analgesic efficacy of erector spinae plane block with rhomboid intercostal subserratus plane block in patients undergoing modified radical mastectomy: A randomised control trial"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0118-2187","authenticated-orcid":false,"given":"Poonam","family":"Kumari","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9262-0682","authenticated-orcid":false,"given":"Athira","family":"Ramesh","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4272-5750","authenticated-orcid":false,"given":"Amarjeet","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5736-9763","authenticated-orcid":false,"given":"Rahul","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4107-2671","authenticated-orcid":false,"given":"Chandni","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1200-731X","authenticated-orcid":false,"given":"Deepak","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Surgery, All India Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"R1-20260520","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.bja.2019.08.014","article-title":"Preventing opioid prescription after major surgery:A scoping review of opioid-free analgesia","volume":"123","author":"Fiore","year":"2019","journal-title":"Br J Anaesth"},{"key":"R2-20260520","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1007\/s00276-017-1857-4","article-title":"Boundaries of the thoracic paravertebral space:Potential risks and benefits of the thoracic paravertebral block from an anatomical perspective","volume":"39","author":"Bouman","year":"2017","journal-title":"Surg Radiol Anat"},{"key":"R3-20260520","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1111\/anae.13498","article-title":"Rhomboid intercostal block","volume":"71","author":"Elsharkawy","year":"2016","journal-title":"Anaesthesia"},{"key":"R4-20260520","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1111\/anae.12344","article-title":"Serratus plane block:A novel ultrasound-guided thoracic wall nerve block","volume":"68","author":"Blanco","year":"2013","journal-title":"Anaesthesia"},{"key":"R5-20260520","doi-asserted-by":"crossref","first-page":"E679","DOI":"10.36076\/ppj.2023.26.E679","article-title":"Analgesic effect of addition of pectointercostal block to serratus anterior plane block in breast surgeries:A randomized controlled trial","volume":"26","author":"Hozien","year":"2023","journal-title":"Pain Physician"},{"key":"R6-20260520","doi-asserted-by":"crossref","first-page":"110647","DOI":"10.1016\/j.jclinane.2022.110647","article-title":"Analgesic efficacy of erector spinae plane block in lumbar spine surgery:A systematic review and meta-analysis","volume":"78","author":"Oh","year":"2022","journal-title":"J Clin Anesth"},{"key":"R7-20260520","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1111\/anae.13814","article-title":"The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP) blocks in patients having ventral hernia repair","volume":"72","author":"Chin","year":"2017","journal-title":"Anaesthesia"},{"key":"R8-20260520","first-page":"E289","article-title":"Evaluation of sensory mapping of erector spinae plane block","volume":"23","author":"Barrios","year":"2020","journal-title":"Pain Physician"},{"key":"R9-20260520","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/AAP.0000000000000750","article-title":"Interfascial plane blocks:Back to basics","volume":"43","author":"Elsharkawy","year":"2018","journal-title":"Reg Anesth Pain Med"},{"key":"R10-20260520","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4103\/joacp.JOACP_245_16","article-title":"ASSIST-Patient satisfaction survey in postoperative pain management from Indian subcontinent","volume":"33","author":"Subramanian","year":"2017","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"R11-20260520","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s12871-019-0700-3","article-title":"Comparison of the efficacy of erector spinae plane block performed with different concentrations of bupivacaine on postoperative analgesia after mastectomy surgery:Ramdomized, prospective, double blinded trial","volume":"19","author":"Alt\u0131parmak","year":"2019","journal-title":"BMC Anesthesiol"},{"key":"R12-20260520","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1097\/AAP.0000000000000451","article-title":"The erector spinae plane block:A novel analgesic technique in thoracic neuropathic pain","volume":"41","author":"Forero","year":"2016","journal-title":"Reg Anesth Pain Med"},{"key":"R13-20260520","doi-asserted-by":"crossref","first-page":"311","DOI":"10.4103\/sja.sja_716_22","article-title":"Ultrasound-guided erector spinae plane block compared to serratus anterior muscle block for postoperative analgesia in modified radical mastectomy surgeries:A randomized control trial","volume":"17","author":"Nyima","year":"2023","journal-title":"Saudi J Anaesth"},{"key":"R14-20260520","doi-asserted-by":"crossref","first-page":"435","DOI":"10.5152\/TJAR.2022.21127","article-title":"Comparison of the efficacy of ultrasound guided serratus anterior plane block versus erector spinae plane block for postoperative analgesia after modified radical mastectomy:A randomised controlled trial","volume":"50","author":"Ahuja","year":"2022","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"R15-20260520","doi-asserted-by":"crossref","first-page":"e122917","DOI":"10.5812\/aapm-122917","article-title":"Erector spinae plane block versus PECS block type II for breast surgery:A randomised controlled trial","volume":"12","author":"Bakeer","year":"2022","journal-title":"Anesth Pain Med"},{"key":"R16-20260520","doi-asserted-by":"crossref","first-page":"e1244","DOI":"10.1097\/PR9.0000000000001244","article-title":"Ultrasound-guided rhomboid intercostal block combined with subserratus plane block vs pectoral nerve block type-2 in analgesia for breast-conserving surgery (randomized, controlled study)","volume":"10","author":"Soliman","year":"2025","journal-title":"Pain Rep"},{"key":"R17-20260520","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1186\/s12871-025-03377-4","article-title":"Ultrasound-guided erector spinae plane block versus rhomboid intercostal sub-serratus plane block for postoperative analgesia in open radical nephrectomy:A randomised clinical study","volume":"25","author":"Eltwab","year":"2025","journal-title":"BMC Anesthesiol"},{"key":"R18-20260520","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s12890-021-01432-7","article-title":"Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery:A prospective randomized-controlled trial","volume":"21","author":"Deng","year":"2021","journal-title":"BMC Pulm Med"}],"container-title":["Indian Journal of 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