Modified Versus Conventional Serratus Anterior Plane Block

Not Applicable

Recruiting

• Conditions: Postoperative Pain, Acute
• Interventions: Drug: 25 ml of bupivacaine 0.25% via serratus anterior block; Drug: 25 ml of bupivacaine 0.25% via modified serratus anterior palne block

• Registration Number: NCT05661253
• Lead Sponsor: Zagazig University

Brief Summary

comparing preemptive analgesia with ultrasound guided modified serratus anterior plane block versus ultrasound guided serratus anterior plane block

Detailed Description

comparing the quality of postoperative analgesia and opioid consumption in patients undergoing Video-Assisted Thoracoscopic Surgery when using preemptive analgesia with ultrasound guided modified serratus anterior plane block versus ultrasound guided serratus anterior plane block

Study Timeline

• Study First Submitted: 2022-12-01
• Study Start: 2022-12-02
• Study First Submitted QC: 2022-12-21
• Study First Posted: 2022-12-22
• Status Verified: 2023-08
• Last Update Submitted: 2023-08-26
• Last Update Posted: 2023-08-29
• Primary Completion: 2023-10-02
• Study Completion: 2023-10-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 99

Inclusion Criteria

• Patient consent.
• both sex.
• Age: 21-70 years old.
• BMI: 18- 30 kg/m2
• ASA: I and II.
• Scheduled for elective unilateral Video-Assisted thoracoscopy under general anesthesia.

Exclusion Criteria

• History of allergy to the local anesthesia agents used in this study,
• Skin lesion at needle insertion site,
• Those receiving anticoagulant therapy or having bleeding disorders
• Patients with history of chronic pain and taking analgesics,
• Patients with sepsis and Significant cardiac, liver or renal diseases
• Uncooperative patients or with psychiatric disorders.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
SAP block group	25 ml of bupivacaine 0.25% via serratus anterior block	After sterilization of the skin and draping, the high frequency linear probe of Sonosite M Turbo ultrasonography (FUJIFIM sonosite, Inc., Bothell, WA, USA) will be placed at the level of the midclavicular line in a sagittal plane. The second rib will be recognized at the axillary artery. The probe will be moved downward to count the ribs until the level of the fifth rib in the mid-axillary line. At this time, the latissimus dorsi muscle (lying superficial) and the serratus anterior muscle (lying deep) will be clearly visualized under ultrasound . Next, A 22-gauge, 80 mm needle (Stimuplex D, B-Braun, Germany) will be inserted in plane relative to the ultrasound probe between the latissimus dorsi and the serratus anterior muscle. After confirming negative aspiration of blood, 1 ml normal saline will be injected for hydro-dissection sign to verify the needle tip, then a volume of 25 ml 0.25% bupivacaine will be injected superficially to serratus anterior muscle. .
modified SAP block group	25 ml of bupivacaine 0.25% via modified serratus anterior palne block	The patient will be placed in the lateral decubitus position according to the selected site of surgical intervention. After sterilization of the skin and draping, the high frequency linear probe of Sonosite M Turbo ultrasonography ( FUJIFIM sonosite, Inc., Bothell, WA, USA) will be placed horizontally midway between tip of the scapula and posterior axillary line to identify the view of latissimus dorsi(lying superficial) and serratus anterior muscle(lying deep) over either the sixth or seventh rib. A 22-gauge, 80 mm needle (Stimuplex D, B-Braun, Germany) will be inserted in plane relative to the ultrasound probe from posteromedial to anterolateral direction toward posterior axillary line till reaching the interfacial plane between latissimus dorsi and serratus anterior muscle . After confirming negative aspiration of blood, 1 ml normal saline will be injected for hydro-dissection sign to verify the needle tip, then a volume of 25 ml 0.25% bupivacaine will be injected .

Primary Outcome Measures

Name	Time	Method
tramadol consumption	at 24 hours postoperative	The amount of tramadol consumption at 24

Secondary Outcome Measures

Name	Time	Method
Time of performance	from ultrasound probe positioning till the end of the block procedure	Time of performance of block defined as time from ultrasound probe positioning till the end of the block procedure
Patient satisfaction	at 24 hous post operative	Patient satisfaction with analgesia in the first 24hours postoperative hours will be Likert scale where 5 is very satisfied and 0 is very dissatisfied.
Time to first dose of rescue analgesia	during the first postoperative 24 hours	Time to first dose of rescue analgesia (VAS \> 3) after surgery

Trial Locations

Locations (1)

Heba M Fathi; 🇪🇬 Zagazig, Egypt