Ultrasound Guided Modified Pectoral Plane (PECS II )Block Versus Erector Spinae Plane (ESP) Block for Perioperative Analgesia of Surgical Treatment of Gynecomastia
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 46
- 试验地点
- 1
- 主要终点
- intraoperative analgesia
研究概览
简要总结
Pain of breast surgery is due to chest wall scar and arm in some cases like carcinoma or due to nerve injury.It is neuropathic or nociceptive pain.Its severity is depending on the extent of surgery and the radiotherapy if needed.
Previous studies proved that local nerve block procedures improved the immediate postoperative pain and decreased the incidence of postoperative pain chronicity .
Also effective control of pain suppresses the surgical stress response minimizes the anaesthestic needs intraoperatively and decreases the opioid needs postoperatively .
Pectoralis nerve(pecs) II block and erector spinae plane (ESP) block are novel procedures that may provide good intraoperative and postoperative analgesia in patients undergoing surgical treatment of gynecomastia.
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
- Single (Care Provider)
入排标准
- 年龄范围
- 18 Years 至 25 Years（Adult）
- 性别
- Male
- 接受健康志愿者
- 是
入选标准
- •Male gender .
- •Age : 18 - 25 years old .
- •Physical status : ASA I - II .
- •Body mass index(BMI) :20-30 kg/m2
- •Surgical treatment of Gynecomastia .
- •Duration of surgery : 60 -120 min
排除标准
- •Patient refusal .
- •History of opioid abuse or chronic analgesic use .
- •Coagulopathy .
- •Allergy to study drugs .
- •Infection in the injection sites.
- •Uncooperative patients.
研究组 & 干预措施
Erector Spinae Plane ( ESP )block (E)
after induction of general anaesthesia in lateral position of the patient where the surgical side up and at T4 level the probe with frequency L4-12t (Logiq e machine) placed lateral to the spine by 3 cm in parasagittal plane the needle (echoplext guge20 length 50 mm ) advanced between the transverse process and the erector spinae muscle at that level 20 ml of 0.25% Bupivacaine and 8 mg dexamethasone injected.
干预措施: PECS II versus ESP (Procedure)
Modified Pectoral Plane (PECSII ) block (P)
done after induction of general anaesthesia in supine position of the patient with his arm of the side of the operation abducted 90 degree with the probe with frequency L4-12t (Logiq e machine) at the midclavicular level and angled infero-laterally,the axillary artery and vein and the second rib identified the probe moved laterally until the pectoralis minor and serratus anterior are identified,the local anesthetic was injected at two points using (echoplext guge20 length 50 mm ) needle:the first injection of 10 ml of 0.25% Bupivacaine and 4 mg dexamethasone injected between the pectoralis major and minor muscles,and the second injection of 20 ml of 0.25% Bupivacaine and 4 mg dexamethasone between the pectoralis minor and serratus anterior muscles .
干预措施: PECS II versus ESP (Procedure)
结局指标
主要结局
intraoperative analgesia
时间窗: 60-120 minuets
measurement of intraoperative mean blood pressure (mmHg)
次要结局
- postoperative analgesia(24 hours)
研究者
manal mohamed rashad
lecturer of anaesthesia
Zagazig University