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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
70
The patients will receive an ultrasound-guided serratus-intercostal plane block after induction of anaesthesia, using 0.25% bupivacaine and 1 μg/kg dexmedetomidine.
The patients will receive an ultrasound-guided erector spinae plane block after induction of anaesthesia, using 0.25% bupivacaine and 1 μg/kg dexmedetomidine.
The local anaesthetic mixture will include 0.25% bupivacaine plus 1 μg/kg dexmedetomidine.
Zagazig university hospital
Zagazig, Egypt
The total opioid consumption.
The total opioid consumption (morphine) in the first 24 hours postoperative.
Time frame: The first 24 hours postoperative.
Time of the first rescue analgesia
Time of the first rescue analgesia needed by the patient when visual analogue pain score ≥4.
Time frame: The first 24 hours postoperative.
The static and dynamic visual analogue scale
The static and dynamic visual analogue scale pain score with score 10 indicates the maximum pain and score 0 indicates no pain.
Time frame: 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.
Time frame: The first 24 hours postoperative.
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