Analgesic Effect of Serratus Plane Block With Adjuvant Agents in Breast Cancer Surgery

Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey75 enrolled

Overview

Pain after breast surgery has been described as moderate to severe in intensity and, if inadequately treated, increases postoperative morbidity, hospital cost, and the incidence of persistent postoperative pain. Serratus anterior plane block is an interfascial injection technique for analgesia of the chest wall. The aim of this study was to investigate the effect of magnesium and dexmedetomidine as adjuvant agents on postoperative analgesia in serratus anterior plane block in patients undergoing modified radical mastectomy.

In this prospective, double-blind, randomised controlled study, a total of 75 patients aged 30-70 years, who were planned for elective modified radical mastectomy after ethics committee approval, were included. Patients were randomly divided into three groups. After induction of general anaesthesia, serratus anterior plane block was applied to all patients. Group B received bupivacaine 30 ml (0.25%), Group D received bupivacaine 30 ml (0.25%) + dexmedetomidine 1μg/kg, Group M received bupivacaine 30 ml (0.25%) + 500 mg magnesium sulphate. Haemodynamic parameters, numerical rating scale (NRS) scores, number of tramadol use with patient-controlled analgesia device, additional analgesic drug consumption and side effects were recorded at 2, 6, 12 and 24 hours postoperatively.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Breast Cancer

Interventions

BupivacainDRUG

In Group B( control group), bupivacaine was given as additional medication in the serratus block application.

Bupivacaine and Magnesium sulfateDRUG

In Group M, bupivacaine and magnesium were given as additional medication in the serratus block application.

Bupivacaine and Dexmedetomidine ile BlokajDRUG

In Group D, bupivacaine and dexmedetomidine were given as additional medication in the serratus block application.

Eligibility

Sex: ALLMin age: 30 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: - 30-70 years old, ASA I-II-III patient group, * Not hypersensitive to the drugs to be used in the study or to the substances contained in them, * No infection or anatomical deformation at the site of intervention, * No antithrombotic treatment and normal coagulation parameters, * Patients who have the consent of themselves or one of their legal guardians. Exclusion Criteria: * Less than 30 years of age, older than 70 years of age or ASA (American Society of Anaesthesiologists) Classification IV, * Receiving antithrombotic therapy with abnormal coagulation parameters, * Infection or anatomical abnormality at the blockage site,

Outcomes

Primary Outcomes

Postoperative analgesic efficacy

Hemodynamic parameters (heart rate, noninvasive mean arterial blood pressure, peripheral oxygen saturation), numerical rating scale (NRS) scores, number of tramadol uses with patient-controlled analgesia device, and additional analgesic drug consumption were recorded at 2, 6, 12, and 24 hours after surgery. The Numerical Rating Scale (NRS) is a subjective scale in which patients rate their pain intensity by selecting a number between 0 and 10. 0 means "no pain," while 10 means "worst pain imaginable." Patients typically rate their pain over the past 24 hours. It can be used in both verbal and written formats.

Time frame: until the 24th hour postoperatively

Secondary Outcomes

Complications due to adjuvant agents

Complications due to adjuvant agents used in serratus plan blockade