A Comparative Study Between Ultrasound Guided Thoracic Paravertebral Block VS Serrartus Anterior Muscle Block in VATS as Regard Their Effectiveness in Post-operative Analgesia

A Comparative Study Between Ultrasound Guided Thoracic Paravertebral Block VS Ultrasound Guided Serrartus Anterior Muscle Block in Video-assisted Thoracoscopic Surgeries.

A comparative study between ultrasound guided thoracic paravertebral block VS ultrasound guided serrartus anterior muscle block in video-assisted thoracoscopic surgeries as regard their effectiveness in post-operative analgesia

The use of loco-regional analgesia is recommended to control postoperative pain after VATS as it allows opioid sparing and facilitates early postoperative rehabilitation. Different loco-regional analgesic techniques could be used to control pain after thoracic surgery such as a paravertebral block, an intercostal block and serratus plane block. In this study, Thoracic paravertebral nerve block will be compared to Serratus anterior nerve block, both will be done Ultrasound guided (USG) using bupivacaine (0.25%) for postoperative analgesia.

Inclusion Criteria:

• Patients American Society of Anesthesiologists physical status (ASA) I to II
• Both sexes.
• Aged ≥ 20 to ≤ 65years.
• Scheduled for VATS under general anesthesia.

Exclusion Criteria:

• Patient's refusal.
• Patients American Society of Anesthesiologists physical status (ASA) III to IV
• Patients with major spine deformities.
• Disruption of the local anatomy, secondary, for instance, to the presence of chest drains or surgical emphysema, resulting in difficulty in ultrasound interpretation and distortion of tissue planes.
• Patients with bleeding disorders and coagulopathy.
• Infection at the injection site.
• Known allergy to local anesthetics.
• Patients with pre-existing myopathy or neuropathy.
• Ipsilateral diaphragmatic paresis.
• Tumors in the paravertebral space at the level of injection.