Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
A large number of patients undergoing major surgical procedures for the management of breast cancer complain of acute and chronic postoperative pain. Morphine administration for acute pain after mastectomy surgery has many side effects. Regional block techniques, such as paravertebral block and thoracic epidural anaesthesia, have possible complications and technical difficulties. So, we will discuss adding dexmedetomidine as an adjuvant to bupivacaine for serratus-intercostal versus erector-spinae plane block to relieve post-mastectomy pain.
Current pain management encompasses regional anaesthetic techniques and systemic administration of analgesia with a synergetic effect on pain. Regional analgesic techniques improve perioperative pain control, reduce opioid consumption and side-effects. We will investigate whether adding dexmedetomidine to bupivacaine for the serratus-intercostal plane block or the erector-spinae plane block during breast surgery could provide better intraoperative and postoperative analgesia, delay the time to first analgesic request, and reduce intraoperative and postoperative analgesic consumption.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Serratus-intercostal plane block | Active Comparator | The patients will receive an ultrasound-guided serratus-intercostal plane block after induction of general anaesthesia and before surgical incision. |
|
| Erector spinae plane block | Active Comparator | The patients will receive an ultrasound-guided erector spinae plane block after induction of general anaesthesia and before surgical incision. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Serratus-intercostal plane block | Procedure | The patients will receive an ultrasound-guided serratus-intercostal plane block after induction of anaesthesia, using 0.25% bupivacaine and 1 μg/kg dexmedetomidine. |
| Measure | Description | Time Frame |
|---|---|---|
| The total opioid consumption. | The total opioid consumption (morphine) in the first 24 hours postoperative. | The first 24 hours postoperative. |
| Measure | Description | Time Frame |
|---|---|---|
| Time of the first rescue analgesia | Time of the first rescue analgesia needed by the patient when visual analogue pain score ≥4. | The first 24 hours postoperative. |
| The static and dynamic visual analogue scale |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Amal Hossieny Gamil Mohamed, MSc | Contact | 01001882257 | +20 | Amaalhossienyy@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Nahla Mohamed Amin, MD | Department of Anesthesia, Intensive Care & Pain Management, Zagazig University | Study Director |
| Samia Mohamed Masoud, MD | Department of Anesthesia, Intensive Care & Pain Management, Zagazig University |
Not provided
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37601524 | Background | Nyima T, Palta S, Saroa R, Kaushik R, Gombar S. Ultrasound-guided erector spinae plane block compared to serratus anterior muscle block for postoperative analgesia in modified radical mastectomy surgeries: A randomized control trial. Saudi J Anaesth. 2023 Jul-Sep;17(3):311-317. doi: 10.4103/sja.sja_716_22. Epub 2023 Jun 22. | |
| 34732440 |
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| D020927 | Dexmedetomidine |
| ID | Term |
|---|---|
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Erector spinae plane block | Procedure | The patients will receive an ultrasound-guided erector spinae plane block after induction of anaesthesia, using 0.25% bupivacaine and 1 μg/kg dexmedetomidine. |
|
| Dexmedetomidine Injection | Drug | The local anaesthetic mixture will include 0.25% bupivacaine plus 1 μg/kg dexmedetomidine. |
|
|
The static and dynamic visual analogue scale pain score with score 10 indicates the maximum pain and score 0 indicates no pain.
| The first 24 hours postoperative. |
| Number of participants with procedure-related adverse events | Associated side effects related to the procedure as vascular or nerve injury, pneumothorax, and local anaesthetic systemic toxicity. | The first 24 hours postoperative. |
| Vanni G, Caiazza G, Materazzo M, Storti G, Pellicciaro M, Buonomo C, Natoli S, Fabbi E, Dauri M. Erector Spinae Plane Block Versus Serratus Plane Block in Breast Conserving Surgery: Alpha Randomized Controlled Trial. Anticancer Res. 2021 Nov;41(11):5667-5676. doi: 10.21873/anticanres.15383. |
| 33622393 | Background | Villa G, Mandarano R, Scire-Calabrisotto C, Rizzelli V, Del Duca M, Montin DP, Paparella L, De Gaudio AR, Romagnoli S. Chronic pain after breast surgery: incidence, associated factors, and impact on quality of life, an observational prospective study. Perioper Med (Lond). 2021 Feb 24;10(1):6. doi: 10.1186/s13741-021-00176-6. |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |