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

Author(s):  
Martina Farag Wahba Mekhaeil ◽  
Ayman Abd Elmaksod Yousef ◽  
Hesham Mohammed Marof ◽  
Shaimaa Farouk Abdelkader

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.

Author(s):  
wei Deng ◽  
Chen-Wei Jiang ◽  
Qinghe Zhou ◽  
fen liu

Background and objectives Breast cancer is one of the most common malignant tumors in women. Herein, we compared the analgesic efficacy of ultrasound-guided rhomboid intercostal nerve block , erector spinae plane block and serratus plane block after modified radical mastectomy of unilateral breast cancer. Methods: A total of 90 patients who underwent modified radical mastectomy for unilateral breast cancer were selected. patients were randomly allocated into three groups receiving ultrasound-guided serratus plane block, erector spinae plane block, and the rhomboid intercostal block group. All groups received 20 mL 0.5% ropivacaine. Within 24 hours after operation, the patient received intravenous injection of tramadol 1-2 mg/kg to relieve pain in the surgical ward. Results: The dosage of tramadol 24-hours postoperatively in the rhomboid intercostal block and erector spinae plane block groups was significantly lower than that in serratus plane block group (P < 0.001). There was no statistical difference in tramadol consumption between the erector spinae plane block and rhomboid intercostal block groups within 24 hours (P = 0.676). The numerical rating scale scores in the erector spinae plane block and rhomboid intercostal block groups at 0.5, 1, 3, 6, 12, 18, and 24 hours postoperatively once patients were active were significantly lower than in the serratus plane block group (P < 0.05 for all comparisons); however, The numerical rating scale scores between rhomboid intercostal block and erector spinae plane block groups did not differ significatively within 24 hours after surgery when patients were active. Conclusions: Ultrasound-guided rhomboid intercostal block and erector spinae plane block can reduce the dosage of tramadol and NRS score compared with serratus plane block after modified radical mastectomy.


2019 ◽  
Vol 45 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Yusheng Yao ◽  
Hao Li ◽  
Qiaolan He ◽  
Tingting Chen ◽  
Yihang Wang ◽  
...  

BackgroundErector spinae plane block (ESPB) is a novel regional anesthesia technique that is gaining popularity for postoperative pain management. This randomized controlled trial evaluated the effect of ESPB on quality of recovery (QoR) in patients undergoing modified radical mastectomy.MethodsEighty-two female patients undergoing modified radical mastectomy were included. Patients were randomly assigned to receive preoperative ultrasound-guided ESPB with either 0.5% ropivacaine or saline. The primary outcome was QoR, assessed 24 hours postoperatively using the 15-item QoR questionnaire (QoR-15). Secondary outcomes included postoperative pain scores, postoperative cumulative opioid consumption, postanesthesia care unit (PACU) discharge time, postoperative nausea or vomiting and dizziness.ResultsGlobal QoR-15 scores 24 hours postoperatively were significantly higher (indicating better quality) in the ESPB group (median 120, IQR 118–124) compared with the control group (median 110, IQR 108.3–112.8), with a median difference of 10 (95% CI 9 to 12, p<0.001). Compared with the control group, ESPB with ropivacaine reduced pain scores up to 8 hours after surgery, as well as reduced postoperative cumulative opioid consumption and PACU discharge time.ConclusionsA single preoperative injection of ESPB with ropivacaine may improve QoR postoperatively and acute postoperative analgesia in patients undergoing a modified radical mastectomy.Trial registration numberChiCTR-1800019599.


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

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.


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