Efficacy of Serratus Anterior Plane Block With Dexmedetomidine During Breast Surgery

Study Overview
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Brief Summary
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This study aims to compare single level serratus block versus bilevel serratus block with and without dexmedetomidine in cancer patients undergoing modified radical mastectomy for breast cancer regarding pain control and possible side effects.

Official Title
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Efficacy of Single Level Versus Bilevel Serratus Anterior Plane Block With Dexmedetomidine During Breast Cancer Surgery

Conditions
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Analgesia

Intervention / Treatment
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* Procedure: Single level serratus anterior plane block
* Procedure: Single level serratus anterior plane block with dexmedetomidine
* Procedure: Bilevel serratus anterior plane block
* Procedure: Bilevel serratus anterior plane block with dexmedetomidine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients scheduled for modified radical mastectomy, Age 18-65 years, ASA I-II Exclusion Criteria: patient refusal, coagulation defects, abnormal kidney or liver functions, local infection at site of injection.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Single level serratus anterior plane block<br>the allocated patients will receive single injection serratus anterior plane block at the level of third rib with local anesthetics only | Procedure: Single level serratus anterior plane block<br>* Serratus anterior plane block with local anesthetics at the third rib<br>|
| Experimental: Single level serratus anterior plane block with dexmedetomidine<br>the allocated patients will receive single injection serratus anterior plane block at the level of third rib with local anesthetics and dexmedetomidine | Procedure: Single level serratus anterior plane block with dexmedetomidine<br>* Serratus anterior plane block with local anesthetics and dexmedetomidine at the third rib<br>|
| Experimental: Bilevel serratus anterior plane block<br>the allocated patients will receive injection serratus anterior plane block at 2 levels, the level of third rib and the level of the fifth rib with local anesthetics only | Procedure: Bilevel serratus anterior plane block<br>* Serratus anterior plane block with local anesthetics at the third and fifth rib<br>|
| Experimental: Bilevel serratus anterior plane block with dexmedetomidine<br>the allocated patients will receive injection serratus anterior plane block at 2 levels, the level of third rib and the level of the fifth rib with local anesthetics and dexmedetomidine | Procedure: Bilevel serratus anterior plane block with dexmedetomidine<br>* Serratus anterior plane block with local anesthetics and dexmedetomidine at the third and fifth rib<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First time to receive analgesia | first time to receive morphine analgesia in hours | First 24 hours postoperatively | 
| Total analgesic requisite | total amount of morphine consumption in the first 24 hours postoperatively in mg | First 24 hours postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain scores | pain scores will be assessed using Visual Analogue Scale on a sale from 0 to 10 with 0 meanung no pain and 10 meaning severe pain | First 24 hours postoperatively | 
| Side effects | nausea and vomiting and hematoma at site of injection | First 24 hours postoperatively | 
| Perioperative heart rate values | heart rate values in the form of beat per minute in the perioperative period including preoperative, intraoperative and postoperative | First 24 hours | 
| Mean arterial blood pressure | Mean arterial blood pressure values in the form mmHg in the perioperative period including preoperative, intraoperative and postoperative | First 24 hours |