Comparative randomized study of continuous serratus anterior plane block versus continuous paravertebral block in post-m
- PDF / 511,214 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 69 Downloads / 214 Views
(2020) 12:45
Ain-Shams Journal of Anesthesiology
ORIGINAL ARTICLE
Open Access
Comparative randomized study of continuous serratus anterior plane block versus continuous paravertebral block in post-mastectomy pain Essam Mahran1* , Suzan Adlan1 and Nelly Alieldeen2
Abstract Background: Many analgesic methods have been used to control post-mastectomy pain. Both thoracic paravertebral and serratus anterior blocks are recent regional techniques with promising results. The aim of this study was to compare safety and analgesic efficacy of both techniques in controlling post-mastectomy pain. Methods: The study was conducted from January 1, 2019, till January 10, 2019, on 60 female patients ASA class ≤ 2 undergoing modified radical mastectomy. After induction of balanced general anesthesia patients received either continuous thoracic paravertebral block (group P) or continuous serratus anterior block (group S). Twenty milliliters of levobupivacaine 0.25% were injected in each technique under ultrasound guidance followed by continuous infusion of 5 ml/h levobupivacaine 0.125% through a 22-gage catheter. IV morphine was given postoperatively by patient-controlled analgesia. In both groups, we measured time to first dose morphine, total 24 and 48 h morphine consumption, vital signs, visual analog scale, and side effects of each technique. Results: The demographic data (age, body mass index, and duration of surgery) were comparable in both groups. The time for first dose of morphine was significantly longer in group P (368 ± 36 min) than group S (270 ± 37.65 min) with P value < 0.001. Total morphine consumption in milligram at both 24 and 48 h were significantly less in group P (8.1 ± 0.8, and 11.5 ± 1 respectively) than in group S (10.1 ± 1.3 and 14.2 ± 1.4), with limited side effects in both groups. Conclusion: Both continuous paravertebral and serratus anterior plane blocks are safe good alternatives to control post-mastectomy pain. However continuous paravertebral block provides better analgesic profile. Keywords: Continuous serratus anterior plane block, Continuous paravertebral block, Post-mastectomy pain
Introduction Breast cancer is one of the most common types of cancer in women, the standard surgery for which is modified radical mastectomy surgery with axillary dissection (MRM) (Cancer Research, 2010; Office for National Statistics, 2010; Sharma et al., 2010; American Cancer Society, 2019). MRM causes acute post-operative pain that * Correspondence: [email protected] 1 Anesthesia, ICU, and Pain therapy department, National Cancer Institute, Cairo University, Cairo, Egypt Full list of author information is available at the end of the article
progresses to chronic persistent pain in 25–60% of cases, hence, the importance of proper control of postmastectomy pain (Andersen & Kehlet, 2011). Regional analgesic methods aiming at blockade of the lateral cutaneous branches of the thoracic intercostal nerves (T2– T12) provide analgesia to the anterolateral chest wall in these patients (Mayes et al., 2016a). This bl
Data Loading...
