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evaluate and compare the impact of ultrasound guided rhomboid intercostal block versus serratus anterior plane block for analgesia after thoracodorsal artery perforator flap following partial mastectomy
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group C: | Active Comparator | control group who will be given general anesthesia only |
|
| Group R: | Active Comparator | Rhomboid intercostal block then general anesthesia |
|
| group S | Active Comparator | Serratus anterior plane block then general anesthesia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| general anesthesia | Procedure | general anesthesia |
|
| Measure | Description | Time Frame |
|---|---|---|
| tramadol consumption | The amount of tramadol consumption | at 24 hours postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Time of performance of block | Time needed to performance the block | time from positioning of ultrasound porbe till the end of block procedure. |
| Time to first dose of rescue analgesia | the first time that the patients need analgesia when VAS ≥ 3 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Heba M Fathi, M.D | Contact | 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 |
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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 |
|---|---|
| D000768 | Anesthesia, General |
| ID | Term |
|---|---|
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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| general anesthesia plus Rhomboid intercostal block | Procedure | the patients will be positioned in lateral decubitus with moving the scapula laterally by abducting the ipsilateral arm across the chest. under complete aseptic situations A high-frequency (6-12 MHz) linear US probe will be put medial to the medial border of the scapula in an oblique sagittal plane with the orientation marker directed cranially.at the T6-7 level, the tissue plain between the rhomboid major and intercostal muscles is identified, and a single injection of 25mL of bupivacaine (0.25%) will be administered via 18-gauge Tuohy advanced in plane from a superomedial to an inferolateral direction, followed by general anesthesia |
|
| Serratus anterior plane block | Procedure | The patient will be positioned supine with his arm abducts at 90°. the US high frequency (6-12 MHz) linear probe of sonosite M turbo ultrasonography (FUJIFIM sonosite, Inc., Bothell, WA, USA) will be put in sagittal plane at the midaxillary line. identification of the fascial plane between the serratus anterior muscle and external intercostal muscles will be performed between the fourth and fifth ribs in the midaxillary area . At this point the18-gauge Tuohy needle will be advanced in plane with injection of 25mL of 0.25 %, bupivacaine. followed by general anesthesia |
|
| during the first 24 hours postoperatively |
| Anticipated side effect | nausea, vomiting, local anesthesia toxicity, needle injury | at 24 hous post operative |
| Post operative patient's satisfaction | Post operative patient's satisfaction using 3 point scale (1= satisfied ,2=neutral, 3=not satisfied) | at 24 hours post operative |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |