The aim of this study is to compare and evaluate the analgesic effects of ultrasound-guided Erector Spinae Plane block using low volumes and high concentrations versus high volumes and low concentrations in patients undergoing MRM.
Multiple regional techniques have been developed in recent years for postoperative analgesia of breast surgery including ESPB aiming to be effective and associated with less complications when compared to the gold standard techniques (thoracic epidural analgesia or paravertebral block).. Ultrasound guided erector spinae plane (ESPB) block was described in 2016 as a novel regional anesthetic technique for acute and chronic thoracic pain, it has been used as a regional anesthetic technique for breast surgery based on case reports and case series. It is a paraspinal fascial plane block that involves injection of local anesthetic deep in the erector spinae muscle and superficial to the tips of the thoracic transverse processes. The site of injection is distant from the pleura, major blood vessels, and spinal cord; hence, performing the ESPB has relatively few contraindications. The injected local anesthetic drug blocks the ventral and dorsal rami of spinal nerves on the paravertebral area . Multiple studies have reported improved efficiency of interfascial blocks by increasing the volume of injection promoting better spread of local anesthesia. According to the authors best knowledge there is no studies comparing different volumes and concentration in ESPB in patients undergoing MRM This study aims to see the effect of fixing the drug mass of anaesthetic given in both groups, while altering the concentration of the anesthetic and total volume administered. One group will receive a lower concentration and higher volume, while the other will receive a higher concentration and lower volume.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
52
Patients will preoperatively receive low concentration-high volume ultasound guided Erector Spinae Plane block, and then the patient will be transferred to the operating room ) one syringe of 30ml bupivacaine 0.25% {15 ml bupivacaine 0.5% and 15ml normal saline} for each patient
Patients will preoperatively receive high concentration-low volume ultasound guided Erector Spinae Plane block, and then the patient will be transferred to the operating room (one syringe of 15 ml bupivacaine 0.5% {15 ml bupivacaine 0.5% } for each patien).
Ahmed Abdalla Mohamed
Cairo, Egypt
Total dose of morphine needed postoperatively
Total dose of morphine needed postoperatively
Time frame: Through Study Completion Up to 1 Day
Time to first rescue analgesia, starting after extubation
Time to first rescue analgesia, starting after extubation
Time frame: Through Study Completion over the first 24 hours postoperative
Duration of surgery
Duration of surgery
Time frame: Through Study Completion 24 hours postoperative
Blood loss,
Blood loss,
Time frame: Through Study Completion,an average of 1day
Total dose of fentanyl required intraoperative (including induction dose)
Total dose of fentanyl required intraoperative (including induction dose)
Time frame: Through study completion,an average of 1day
Pain score at 15, 30, 45 and 60 min., 3,6,12 and 24 h after surgery
Pain score at 15, 30, 45 and 60 min., 3,6,12 and 24 h after surgery
Time frame: through study completion,an average of 1day
Need for blood transfusion
Need for blood transfusion
Time frame: Through Study Completion over the first 24 hours postoperative
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.