Effect of Preoperative Ultrasound Guided Thoracic Interfascial Plane Block Versus Preoperative Thoracic Erector Spinae Plane Block on Acute and Chronic Pain After Modified Radical Mastectomy
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Pain, Acute
- Sponsor
- Tanta University
- Enrollment
- 90
- Primary Endpoint
- Total analgesics consumption in the first 24h after surgery.
- Last Updated
- 4 years ago
Overview
Brief Summary
This study will be conducted to compare the efficacy of ultrasound guided thoracic interfascial plane block versus ultrasound guided erector spinae plane block on acute and chronic pain after modified radical mastectomy surgery.
Detailed Description
Various thoracic nerve blocks performed for pain control after breast cancer surgery provide superior analgesic effect and reduce postoperative nausea and vomiting as a result of the decreased use of opioid analgesics. Ultrasound-guided erector spinae block (ESB) is a regional anesthesia technique; recently described by Forero et al, in management of thoracic neuropathic pain. It became popular because it is much safer and easily administered than other alternative regional techniques as paravertebral and thoracic epidural block. ESB leads to effective postoperative analgesia when performed at T 4-5 level for breast and thoracic surgery, and T 7 level for abdominal surgeries. Spread of local anesthetic following ESB in the cephalic and caudal directions can lead to analgesia from C7 to L2-3. There have been several reports that thoracic interfascial plane block is useful for multimodal analgesia in patients undergoing mastectomy, Thoracic interfascial plane block including pecto-intercostal fascial plane block (PIFB) and serratus intercostal fascial plane block (SIFB). Thoracic interfascial plane block is the peripheral nerve block that targets the intercostal nerves branches distributed in the chest and axilla, Although PIFB and SIFB are thought to be relatively easy to perform there have been no reports of the simultaneous performance of the two blocks.
Investigators
Areeg Kotb Ghalwash
Assistant lecturer of Anesthesiology and Surgical Intensive Care and Pain Medicine
Tanta University
Eligibility Criteria
Inclusion Criteria
- •Female patients admitted for modified radical mastectomy surgery.
- •American Society of Anesthesiologists (ASA) physical activity I, II
- •Aged (18 - 65) years
Exclusion Criteria
- •Patient refusal.
- •Patient with neurological deficit.
- •Patient with bleeding disorders (coagulopathy, thrombocytopenia anticoagulant, and antiplatelet drugs).
- •Uncooperative patient.
- •Infection at the block injection site.
- •Patients with a history of allergy to drugs.
Outcomes
Primary Outcomes
Total analgesics consumption in the first 24h after surgery.
Time Frame: 24 hours postoperative
Total analgesic consumption (fentanyl intraoperative) and (morphine 0.05 mg / kg per dose at the first 24 h after surgery).
Secondary Outcomes
- Time to first analgesic request after surgery(24 hours Postoperative)
- Visual Analogue score (VAS)(24 hours Postoperative)
- Complications occurrence (hypotension, pneumothorax, bradycardia)(24 hours Postoperative)