Pectoral Nerves I, II and Serratus Plane Blocks in Multimodal Analgesia for Mastectomies A Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- Change in Pain score over 24 hours
研究概览
简要总结
Acute postoperative pain is a common problem faced by the patient after surgery, most frequently occurring in first 24 hours. Our primary objective was to assess pain score in first 24 hours in PECS block group undergoing mastectomies. Secondary objective was to observe morphine (opioids) and antiemetic consumption in post anesthetic care unit.
详细描述
Design: Observer Blinded Randomized control trial.
Place and Duration: Department of Anesthesiology, Shaukat Khanum Memorial Cancer Hospital Lahore (SKMCH), from February 2017 to December 2017
Methods: 120 patients more than 18 years, ASA I and II, planned for unilateral elective modified radical mastectomy under general anesthesia were randomly assigned to receive either general anesthesia plus Pectoral Nerve I, II and serratus (PECS) block (n = 60) or general anesthesia alone (n = 60). Pain score at fixed intervals was measured using Numeric Pain Rating Score (NPRS) after surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
Registered pain nurse
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Female age 18 or older
- •(ASA) I and II
- •Scheduled to undergo elective unilateral mastectomy or Modified radical mastectomy (MRM) under general anesthesia.
排除标准
- •Patient's refusal
- •history of allergy to bupivacaine
- •contraindications to regional anaesthesia (coagulopathy and local infection),
- •BMI > 40 kg/m2,
- •patient scheduled for bilateral mastectomies
- •use of chronic pain medications
- •history of illicit drugs or alcohol abuse and history of psychiatric problems.
研究组 & 干预措施
PECS block group
20ml of 0.25% bupivacaine was infiltrated between pectoralis major and pectoralis minor muscle and the spread was visualised on the ultrasound screen. similarly, in Serratus plane block, ultrasound probe was placed over the mid-axillary region of the thoracic cage in a sagittal plane. Ribs were identified inferiorly and laterally, until the identification of the 3rd rib in the mid axillary line. 10 ml of 0.25% bupivacaine was infiltrated in between Serratus anterior muscle and Latissimus Dorsi muscle
干预措施: PECS block (Procedure)
Control group
Patient were given multimodal analgesia without the regional block
结局指标
主要结局
Change in Pain score over 24 hours
时间窗: First 24 hrs
Patient's pain intensity was assessed using NPRS (Numeric Pain scoring system). Pain score was assessed at the time of arrival at PACU (0 minute) and then at 30 minutes after surgery and at discharge from PACU. Pain score was then assessed at the surgical floor at 6hours, 12hours and 24hours.
次要结局
- Post operative morphine (opioids) consumption in PACU(first 24 hours)
- Antiemetic consumption for treatment of PONV(120 minutes)
研究者
Hammad Najeeb
Fellow in Anesthesia
Shaukat Khanum Memorial Cancer Hospital & Research Centre