Modified Pectoral Nerve Block Versus Serratus Plane Block for Analgesia After Breast Cancer Surgeries
试验速览
- 阶段
- 不适用
- 入组人数
- 60
- 主要终点
- assess analgesic effect of nerve block
研究概览
简要总结
In PECSII or modified PECSI block, local anesthetic (LA) is injected between pectoralis major muscle (PMm) and pectoralis minor muscle (Pmm) to block lateral and medial pectoral nerves and between pectoralis minor muscle (Pmm) and serratus anterior muscle in the anterior axillary line to block the intercostal nerves II-VI (Blanco et al., 2012).
In Serratus anterior plane block (SAPB) local anesthetic (LA) is injected above the serratus muscle (between latissmus dorsi muscle and serratus muscle) or below the serratus muscle (between serratus muscle and 4th rib) in the mid-axillary line to block the intercostal nerves II-VI and spares the pectoral nerves (Blanco et al., 2013).
详细描述
One hour before induction of anesthesia 4ml blood sample will be taken from all patient to measure serum cortisol and serum endorphin level 2ml for each.
General anesthesia will be induced for all patients in both groups using the same protocol.
Anesthesia will be induced with propfol (2-3 mg/kg), IV rocuroniom (.5 - .8 mg/kg) to facilitate endotracheal intubation. Anesthesia will be maintained with isoflurane (1-2 mac) in 100% oxygen.
All patients will be intubated and mechanically ventilated using volume controlled positive pressure ventilation with a tidal volume of 6-8 ml/kg and an inspiratory to expiratory ratio of 1:2 targeting end tidal carbon dioxide tension around 35mmhg.
Basic monitoring for all patients include under pulse oximetry, non-invasive blood pressure, 5 lead electrocardiogram and end tidal carbon dioxide monitoring.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 20 Years 至 60 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Breast cancer surgery.
- •Age 20 to 60 years.
- •Female patients.
- •At least 24 hours post-operative hospital admission.
- •ASA (American society of anesthesiologist) physical status classification system І to Ш.
排除标准
- •• Morbid obesity (body mass index > 40).
- •Impossibility of anatomical structures identification by ultrasound in a satisfactory way (there can be no distinction in the interfacial plan between serratus and pectoral muscle).
- •Opioids treatment before surgery or substance abuse.
- •Sepsis and/or infection at the puncture site.
- •Hemostasis disorders.
- •Allergy to any of the drugs used in the study.
- •Less than 24 hours postoperative hospital admission.
- •Inability to communicate with the patient.
结局指标
主要结局
assess analgesic effect of nerve block
时间窗: 24hour post-operative
We assess the analgesic effect by VAS ( visual analogue scale )
次要结局
未报告次要终点
研究者
Mohamed Hussin Mohamed
principal investigator
Sohag University