Serratus Anterior Block and Erector Spinae Block in Postoperative Analgesia

Study Overview
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Brief Summary
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90 patients scheduled for thoracic cancer surgeries, allocated in 3 groups for serratus anterior block and erector spinae block and control group. during anaesthesia:total intraoperative fentanyl required will be recorded. After surgery, all patients will be connected to PCA device containing morphine solution, the amount of morphine consumed during the first 24 hours will be recorded.

Detailed Description
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90 patients scheduled for thoracic cancer surgeries, allocated in 3 groups for serratus anterior block (SAB) and erector spinae block (ESB) and control group. During anaesthesia: total intraoperative fentanyl required will be recorded. After surgery, all patients will be connected to PCA device containing morphine solution, the amount of morphine consumed during the first 24 hours will be recorded. Other secondary outcomes are: numerical rating scales and postoperative pulmonary functions.

Official Title
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Evaluation of the Effect of Serratus Anterior Block and Erector Spinae Block on Postoperative Analgesia in Thoracic Surgeries

Conditions
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Postoperative Analgesia

Intervention / Treatment
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* Procedure: Serratus anterior block (SAB)
* Procedure: Erector spinae block
* Drug: Saline (as a placebo)
* Drug: Bupivacaine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with class II physical status (American Society of Anaesthesiologists) , Age between 18-70 years, Scheduled for thoracic cancer surgery Exclusion Criteria: Patient refusal. Local infection at the site of the block. Cardiac dysfunction (ejection fraction <45%). Significant respiratory disorders. Preexisting neurological or psychiatric disease. Allergy to one of the study drugs. Pregnancy. Coagulopathy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: serratus anterior block<br>serratus anterior block with 20 ml bupivacaine | Procedure: Serratus anterior block (SAB)<br>* Patients will receive a sonar guided serratus anterior plane block with 20 ml of bupivacaine 0.5%<br>* Other names: SAB group;Drug: Bupivacaine<br>* bupivacaine<br>|
| Experimental: erector spinae block<br>erector spinae block with 20 ml bupivacaine | Procedure: Erector spinae block<br>* Patients will receive a sonar-guided erector spinae plane block with 20 ml of bupivacaine 0.5%<br>* Other names: ESB group;Drug: Bupivacaine<br>* bupivacaine<br>|
| Sham Comparator: control group<br>sham block with 20 ml saline | Drug: Saline (as a placebo)<br>* Patients will receive a sham block with 20 ml saline (as a placebo)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total morphine consumption in first postoperative 24 hours | the amount of morphine required to relieve pain will be recorded | first 24 postoperative hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intraoperative fentanyl requirement | the amount of fentanyl required during anaesthesia will be recorded | during anaesthesia | 
| numerical rating scale | numerical rating scale (from 0 to 10, where 0 represents no pain and 10 represents the worst imaginable pain) will be recorded in different time intervals during the first 24 hours after surgery | the first 24 postoperative hours | 
| pulmonary functions | FVC and FEV1 will be recorded at 24 hours after surgery | 24 hours after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Serratus anterior block, Erector spinae block, Postoperative analgesia