A Comparative Study for Evaluation of the Analgesic Profile of Ultrasound-Guided Modified Pectoral Nerves Block Versus Serratus Plane Block in Major Breast Cancer Surgery
Overview
- Phase
- Phase 2
- Intervention
- Bupivacaine 0.25% with epinephrine
- Conditions
- Postoperative Pain
- Sponsor
- Cairo University
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- Fentanyl consumption
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
The purpose of this study is to compare the analgesic profile of modified pectoral nerves block and serratus plane block in patients undergoing mastectomy.
Detailed Description
This study includes three groups. The first group will receive ultrasound-guided modified pectoral nerves block prior to induction of general anesthesia. The second one will receive ultrasound-guided serratus plane block prior to induction of general anesthesia. The third one will not receive any block preoperatively.
Investigators
Khaled Mostafa Kamel
Assistant Lecturer of Anesthesia and Pain Relief
Cairo University
Eligibility Criteria
Inclusion Criteria
- •American Society of Anesthesiologists( ASA) I or II and scheduled for major breast cancer surgery( modified radical mastectomy or conservative mastectomy with axillary evacuation).
Exclusion Criteria
- •Local infection at the site of the block, coagulations abnormalities, allergy to local anesthetics or morphine, body mass index\> 35, patient refusal, severe respiratory or cardiac disorders, pre-existing neurological deficits, hepatic or renal insufficiency, chronic pain syndrome, chronic analgesic use and psychiatric disorders.
Arms & Interventions
modified pectoral nerves block
Modified pectoral nerves block with general anesthesia. Using the ultrasound, 10 ml of bupivacaine 0.25% with epinephrine 5 ug/ml will be injected in the plane between the pectoralis major and minor muscles. And another 20 ml of bupivacaine 0.25% with epinephrine 5 ug/ml will be injected in the plane between the pectoralis minor and the serratus anterior muscles.
Intervention: Bupivacaine 0.25% with epinephrine
serratus plane block
Serratus plane block with general anesthesia. Using the ultrasound, 0.4 ml of bupivacaine 0.25% with epinephrine 5 ug/ml will be injected in the plane between the serratus anterior muscle and the underlying ribs.
Intervention: Bupivacaine 0.25% with epinephrine
Outcomes
Primary Outcomes
Fentanyl consumption
Time Frame: Intraoperative
Total morphine consumption
Time Frame: The first 24 hours postoperative
Visual analogue scale score at rest and during shoulder movement
Time Frame: The first 24 hours postoperative
Secondary Outcomes
- Nausea and vomiting(The first 24 hours postoperative)
- Mean arterial blood pressure(Preincision, 1 minute postincision, 1 hour postincision, 4, 8, 12, 24 hours postoperative)
- Heart rate(Preincision, 1 minute postincision, 1 hour postincision, 4, 8, 12, 24 hours postoperative)
- Time to first requirement of rescue analgesia(The first 24 hours postoperative)
- Sedation score(Immediate postoperative, 1, 4, 8, 12, 24 hours postoperative)
- Respiratory rate(Immediate postoperative, 1, 4, 8, 12, 24 hours postoperative)
- Patient satisfaction with postoperative analgesia(One week after surgery)