scholarly journals COMPARISION BETWEEN ULTRASOUND GUIDED SERRATUS ANTERIOR PLANE BLOCK AND THORACIC EPIDURAL FOR POSTOPERATIVE ANALGESIA AFTER MODIFIED RADICAL MASTECTOMY

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Mohamed Abd El-Hameed
Keyword(s):  
Postoperative Analgesia ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Thoracic Epidural ◽  
Anterior Plane

Comparative Study between the Effect of Ultrasound Guided Pectoral Nerve Block (PEC 1) versus Serratus Anterior Plane Block (SAPB) For Postoperative Analgesia in Modified Radical Mastectomy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Abd El-Rahman Abd El-Megeed ◽  
Alaa Eid Mohamed Hassan ◽  
Tarek Mohamed Ahmed Ashour ◽  
Ahmed Mounir Ahmed Youssef
Keyword(s):  
Nerve Block ◽  
Postoperative Analgesia ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Female Population ◽  
Pectoral Nerve ◽  
Group I ◽  
Anterior Plane

Abstract Background Breast cancer has continued to be the most common cancer afflicting women, accounting for 31% of all new cancer cases in the female population. Every year, thousands of patients undergo surgery in the region of the breast and axilla. Surgery is one of the mainstays of treatment, and a procedure called modified radical mastectomy (MRM) is now a standard surgical treatment for earlystage breast cancers. Objectives The aim of this work is to evaluate the Effectiveness of Ultrasound Guided Pectoral nerve block (PEC1) versus Serratus Anterior plane block (SAPB) for postoperative Analgesia in Modified Radical Mastectomy Patients and Methods After obtaining approval from the medical ethical committee in Ain Shams University This study was conducted in the operating theatres of Ain Shams University Hospitals. It included Thirty Female patients undergoing Modified Radical Mastectomy were divided randomly into two groups, each group consisted of 15 patients group I in which patients received PEC 1 and group II in which patients received Serratus Anterior Plane Block (SAPB). Results The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first for analgesic need and total consumption of opioid and analgesic in the 1st 24 postoperative hours. Demographic data and post operative hemodynamics were also assessed. Conclusion SAPB was effective in reducing postoperative pain scores for 6 -12 hours and lower total 24-h postoperative opioid and analgesic consumption after Modified Radical Mastectomy under general anesthesia, compared to PEC 1 block.

scholarly journals Prospective Study: The Analgesic Efficacy of Ultrasound-Guided Erector Spinae Plane Block versus Serratus Plane Block in Patients Undergoing Modified Radical Mastectomy

2021 ◽  
pp. 9-18
Author(s):  
Martina Farag Wahba Mekhaeil ◽  
Ayman Abd Elmaksod Yousef ◽  
Hesham Mohammed Marof ◽  
Shaimaa Farouk Abdelkader
Keyword(s):  
Radical Mastectomy ◽  
Analgesic Efficacy ◽  
Erector Spinae ◽  
Control Group ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Group Iii ◽  
Erector Spinae Plane Block ◽  
Group I

Background: Breast Cancer is the most commonly occurring cancer affecting ‎women undergoing modified radical mastectomy, causing acute pain, and in ‎high percentage of patients it progresses to chronic pain syndromes. The Erector Spinae Plane Block (ESPB) ‎and Serratus Anterior Plane Block (SAPB) are options of regional anesthesia that can produce reliable ‎analgesia. In this study we aimed to evaluate the analgesic efficacy of ‎ultrasound guided ESPB and SAPB in patients underwent modified radical ‎mastectomy operation. Patients and Methods: Patients were randomly classified using computer generated numbers ‎concealed in ‎ sealed opaque envelopes into three equal groups; 30 patients ‎were enrolled in each group. ‎Group I: Control Group (C): Patients received intravenous (IV) systemic analgesia only, Group II: ESPB group: Patients received ‎ipsilateral ultrasound guided ESPB using 20 ml bupivacaine 0.25% at the ‎level of the 4th thoracic segment (T4). and Group III: SPB group: Patients received ipsilateral ‎serratus plane block using 30 ml bupivacaine 0.25% at the level of the 5th rib.‎ Results: In this study, 113 patients were assessed for eligibility, 16 patients ‎did not meet the criteria and 7 patients refused to participate in the study. ‎The remaining 90 patients were randomly allocated into three groups (30 ‎patients in each). All patients (90) were followed-up and analyzed ‎statistically‎. Conclusion: Ultrasound-guided SAPB and ESPB provided effective post-‎operative analgesia in patients undergoing modified radical mastectomy with ‎lower pain scores, less peri operative analgesic consumption and longer ‎duration of analgesia in SAPB.

scholarly journals Ultrasound-Guided Transversus Thoracic Muscle Plane-Pectoral Nerve Block for Postoperative Analgesia After Modified Radical Mastectomy: A Comparison with the Thoracic Paravertebral Nerve Block

2021 ◽  
Author(s):  
Ying Zhao ◽  
Weilin Jin ◽  
Peng Pan ◽  
Shuquan Feng ◽  
Danyun Fu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Inflammatory Response ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Flurbiprofen Axetil ◽  
Pectoral Nerve ◽  
Fentanyl Consumption

Abstract Background: Modified radical mastectomy (MRM) is a most effective and common type of invasive surgery for breast cancer. However, it causes moderate to severe acute pain even last for a long postoperative period. Transversus thoracic muscle plane-pectoral nerve block (TTP-PECS) is a novel and promising interfacial plane block which can provide analgesia for MRM while thoracic paravertebral nerve block (TPVB) is also widely used for this purpose. This study compared the postoperative analgesia between the ultrasound-guided TTP-PECS and TPVB in patients undergoing MRM.Methods: In this randomized controlled pilot trial, eighty female breast cancer patients were randomized to receive either ultrasound-guided TTP-PECS (TTP-PECS group, n=40) or TPVB (TPVB group, n=40). The primary outcome was 24 h postoperative fentanyl consumption. Secondary outcome measures included intraoperative fentanyl and postoperative flurbiprofen axetil consumption, duration of analgesia, pain intensity at rest and during activity, inflammatory response, and the quality of recovery 40 (QoR-40) score.Results: Intraoperative fentanyl requirement was similar between the two groups; Postoperative fentanyl consumption was decreased in the TTP-PECS group copmared with the TPVB group, as well as the rate of postoperative flurbiprofen axetil consumption, but the duration of analgesia was longer; Pain scores at rest and during activity were dramatically decreased at postoperative 12 h; Moreover, the levels of IL-6, MCP-1 and TNF-α, as well as the levels of PGE2, NPY and β-endorphins were decreased at 12 h after surgery; Finally, the total QoR-40 score, especially for the scores of pain, emotional state and patient support were increased.Conclusion: Both TTP-PECS and TPVB are effective for analgesia after MRM. However, TTP-PECS reduced postoperative fentanyl and flurbiprofen axetil consumption in the first 24 h after MRM, and prolonged the duration of analgesia. Furthermore, TTP-PECS reduced postoperative pain intensity at rest and during activity, and inflammatory response at 12 h postoperation. Finally, TTP-PECS improved QoR-40 scores on the postoperative day. Thus, TTP-PECS is an attractive alternative to TPVB for postoperative analgesia after MRM.

scholarly journals COMPARISON OF ULTRASOUND-GUIDED THORACIC PARAVERTEBRAL AND PECTORALIS INTERFASCIAL PLANE BLOCK FOR MODIFIED RADICAL MASTECTOMY

2021 ◽  
Vol 9 (11) ◽  
pp. 73-79
Author(s):  
Kalyani Nilesh Patil ◽  
◽  
Shalini Pravin Sardesai ◽  
Poonam Ghodki ◽  
Rajlaxmi Menghal ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Randomized Study ◽  
Radical Mastectomy ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided

Aims and Objectives : To compare the efficacy of ultrasound-guided thoracic paravertebral block(TPVB) and ultrasound-guided pectoralis interfascial plane (PECS) block for Modified Radical Mastectomy (MRM). The primary objectives were to compare duration of post-operative analgesia and total post-operative analgesic consumption while the secondary objectives were to compare dermatomal spread, intraoperative anaesthesia requirement and patient satisfaction. Materials And Methods: Sixty female patients of American Society of Anaesthesiologists (ASA) physical status I and II, undergoing MRM under general anaesthesia, were randomly recruited to receive ultrasound-guided TPVB (Group T) or ultrasound-guided PECS block (Group P) with 25ml of 0.25% bupivacaine, in a prospective, observer-blinded, randomized study. Data was statistically analysed using Statistical Package for Social Sciences (SPSS) version 21.0. Categorical variables were compared using the Chi-square test or Fishers exact probability test continuous variables compared using unpaired t-test or Mann-Whitney U test. Results: All demographic variables were comparable. Intraoperative fentanyl consumption was lower in patients who received PECS block (72.50+27.35) than those who received TPVB (104.17+46.92) (p=0.0023). NRS was comparable in both groups till 2 hours post operatively. However, from 4 hours onwards, till 18 hours the Numerical Rating Scale (NRS) was significantly higher in TPVB group. Dermatomal spread was more extensive and postoperative analgesia requirement was lower in Group P. Patient satisfaction was comparable in both groups. Conclusion: PECS block is associated with superior postoperative analgesia and reduced analgesic requirement. The cranial dermatomal spread was better and intraoperative opioid requirement was less with PECS block.

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