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comparing preemptive analgesia with ultrasound guided modified serratus anterior plane block versus ultrasound guided serratus anterior plane block
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
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | No Intervention | will take general anesthesia without nerve block | |
| SAP block group | Active Comparator | 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 | Active Comparator | 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 . |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 25 ml of bupivacaine 0.25% via serratus anterior block | Drug | patients will receive conventional serratus anterior plane block with a volume of 25 ml of bupivacaine 0.25% followed by induction of general anesthesia, |
| Measure | Description | Time Frame |
|---|---|---|
| tramadol consumption | The amount of tramadol consumption at 24 | at 24 hours postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Time of performance | Time of performance of block defined as time from ultrasound probe positioning till the end of the block procedure | from ultrasound probe positioning till the end of the block procedure |
| Time to first dose of rescue analgesia |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Heba M Fathi | Contact | 002-01000143938 | heba_elgendi@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| Heba M Fathi | faculty of human medicine ,zagazig university | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Heba M Fathi | Recruiting | Zagazig | 44519 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40883665 | Derived | Abd Ellatif SE, Galal Eldin AM, Ali ES, Fathi HM. Ultrasound-guided modified versus conventional serratus anterior plane block as a preemptive analgesic for unilateral video-assisted thoracoscopic surgery. BMC Anesthesiol. 2025 Aug 29;25(1):435. doi: 10.1186/s12871-025-03314-5. |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D002045 | Bupivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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|
| 25 ml of bupivacaine 0.25% via modified serratus anterior palne block | Drug | patients will receive modified serratus anterior plane block with a volume of 25 ml of bupivacaine 0.25% followed by induction of general anesthesia. |
|
Time to first dose of rescue analgesia (VAS > 3) after surgery
| during the first postoperative 24 hours |
| Patient satisfaction | Patient satisfaction with analgesia in the first 24hours postoperative hours will be Likert scale where 5 is very satisfied and 0 is very dissatisfied. | at 24 hous post operative |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D000588 |
| Amines |