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The Pecs block (pectoral nerves block) is an easy and reliable superficial block inspired by the infraclavicular block approach and the intercostal abdominis plane blocks . Many additives were used in combination with local anesthetics in Pecs block to prolong the postoperative analgesia (fentanyl, dexmedetomidine).
60 patients scheduled for modified radical mastectomy surgery under general anesthesia. Group I (Bupivacaine group): patients underwent modified radical mastectomy were given preoperative ultrasound guided modified Pecs block with 30 mL of 0.25% bupivacaine divided into 10 ml injected between the pectoralis muscles on the interfascial plane, and 20 ml injected between the Pectoralis minor muscle and the serratus muscle.Group II (Bupivacaine + Dexmedetomidine group) : preoperative ultrasound guided modified Pecs block with 30 mL of 0.25% bupivacaine plus Dexmedetomidine (1 µg/kg) divided into 20 ml injected between the pectoralis muscles on the interfascial plane , and 10 ml injected between the Pectoralis minor muscle and the serratus muscle.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I (Bupivacaine group) | Placebo Comparator | ultrasound guided modified Pec's block with 30 mL of 0.25% bupivacaine divided into 10 ml injected between the pectoralis muscles and 20 ml between the Pectoralis minor muscle and the serratus muscle |
|
| Dexmedetomidine Injection [Precedex] | Active Comparator | ultrasound guided modified Pecs block with 30 mL of 0.25% bupivacaine plus Dexmedetomidine Injection [Precedex] (1 µg/kg) divided into 20 ml injected between the pectoralis muscles and 10 ml injected between the Pectoralis minor muscle and the serratus muscle. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexmedetomidine Injection [Precedex] | Drug | ultrasound guided modified Pecs block with 30 mL of 0.25% bupivacaine (markyrene R sigma -Tec, Egypt) plus (1 µg/kg) Dexmedetomidine Injection [Precedex] |
| Measure | Description | Time Frame |
|---|---|---|
| I.V patient controlled analgesia (PCA) morphine consumption | the total dose of I.V patient controlled analgesia (PCA) morphine consumption in the first 48 hours postoperative | 48 hours postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| pain relief | by visual analogue scale measurement | 48 hour |
| Measure | Description | Time Frame |
|---|---|---|
| stress response | Three Blood samples were collected from each patient for detection of cortisol & prolactin levels, the first was preoperative, the second and the third were 1h and 24 h postoperatively | 24 hour |
Inclusion Criteria:
ASA I - II patients
age 18-60 years
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| sahar m abd elbaqy, professor | manager | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| South EGYPT cancer institute | Asyut | 088 | Egypt |
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| ID | Term |
|---|---|
| D020927 | Dexmedetomidine |
| D002045 | Bupivacaine |
| ID | Term |
|---|---|
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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|
| Bupivacaine Injection [Marcaine] | Drug | ultrasound guided modified Pec's block with 30 mL of 0.25% bupivacaine divided into 10 ml injected between the pectoralis muscles and 20 ml between the Pectoralis minor muscle and the serratus muscl |
|
| D000813 |
| Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |