Perioperative Analgesic Modalities for Breast Cancer Surgeries
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 75
- 试验地点
- 1
- 主要终点
- Visual analogue score
研究概览
简要总结
The incidence of breast cancer is among women world wide, detection increased with introduction of mammography as a screening tool. surgical resection of breast cancer contributes to the generation of acute and chronic post mastectomy pain. This study aims at comparing the effect of erector spinae block versus serratus block versus intravenous morphine in patients undergoing modified radical mastectomy for breast cancer surgeries regarding pain control and possible side effects
详细描述
One of the most common types of cancer affecting women is breast cancer. Surgical resection is one of the main approaches applied for solid tumors. surgical approach for breast cancer involve the breast region. Various analgesic modalities are used for proper perioperative pain control. Morphine has always been considered as the gold standard analgesic, however opioids have multiple side effects. Several loco-regional techniques have been introduced for breast surgery pain management including serratus plane block (SPB) and erector spinae plane (ESP) block. In this study the investigators are comparing the effect of erector spinae block versus serratus block versus intravenous morphine in patients undergoing modified radical mastectomy for breast cancer surgeries regarding intraoperative and postoperative analgesia, time to first analgesic, any possible side effects
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •female 18-65 years old patients undergoing modified radical mastectomy
排除标准
- •patient refusal, local infection at site of block coagulation defect abnormal kidney or liver functions
研究组 & 干预措施
erector spinae block
Ultrasound guided erector spinae block with will be done after induction of intravenous anesthesia. After identification of trapezius, rhomboid major, and erector spinae muscles. The needle will be inserted in a cephalad-to-caudal direction until the tip contact transverse process and the needle tip is visualized in the plane deep to the erector spinae muscle. The needle tip position is confirmed by visualizing linear spread of test dose between the muscles after injection. A total dose of 25 mL of 0.25% bupivacaine will be injected.
干预措施: erector spinae block (Procedure)
serratus anterior block
Ultrasound guided serratus anterior block will be done after induction of intravenous anesthesia. The serratus anterior, latissimus dorsi, and the intercostal muscles will be identified in the fourth and fifth intercostal level, an 18 G Tuohy needle will be advanced in the plane between the serratus anterior muscle and the intercostal muscles. A total dose of bupivacaine 25ml in a concentration of 0.25% will be administered under the serratus muscle after a test dose using an in-plane technique.
干预措施: serratus plane block (Procedure)
intravenous morphine
intravenous morphine will be administrated in a dose of 0.1 mg per kg after induction of general anesthesia
干预措施: Morphine Sulfate (Drug)
结局指标
主要结局
Visual analogue score
时间窗: 24 hours
minimum score (0), maximum score (10) maximum score (10)
Total morphine consumption
时间窗: 24 hours
total morphine in mg received in first 24 hours postoprative
First time to receive morphine
时间窗: 24 hours
first time to receive morphine in the postoperative period (first 24 hours)
次要结局
- mean arterial blood pressure(24 hours)
- heart rate(24 hours)
研究者
Walaa Youssef Elsabeeny
lecturer of anesthesia and pain management
National Cancer Institute, Egypt