Comparison Between Serratus Anterior Plane Block and Erector Spinae Plane Block for Mastectomy

Study Overview
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Brief Summary
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In this study, we are comparing two different techniques of plane blocks to control postoperative mastectomy pain serratus anterior plane block and erector spinae plane block, both are done with ultrasonic guidance We are recording the first time of analgesia request postoperatively as a primary outcome

Official Title
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Comparison Between Serratus Anterior Plane Block and Erector Spinae Plane Block to Control Postmastectomy Pain

Conditions
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Breast Cancer Postoperative Pain

Intervention / Treatment
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* Procedure: Plane block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female patient age 20 to 65 ASA I, II Scheduled for mastectomy Exclusion Criteria: Allergy to local anaesthetics Infection at the site of performing the block Morbidly obese patient of body mass index more than 40 kg/m2

Ages Eligible for Study
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Minimum Age: 20 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
Interventional Model Description: prospective comparative randomized clinical trial
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Serratus anterior plane block<br>Serratus anterior plane block was performed in the supine position placing the ipsilateral upper limb in abduction 90 degrees position. Aiming to find the serratus anterior muscle the investigator identified the fifth rib in the mid-axillary line by the linear probe in the sagittal plane. The latissimus dorsi muscle (superficial and posterior), teres major muscle (superior) and serratus muscles (deep and inferior) were detected using ultrasound. The investigator penetrated the serratus anterior muscle by a 25 GA, 90 mm spinal needle in-plane concerning the ultrasound probe from superoanterior to posteroinferior to inject deep to it. | Procedure: Plane block<br>* Two different plane blocks to control post-mastectomy pain<br>* Other names: Block;|
| Active Comparator: Erector spinae plane block<br>Erector spinae plane block was performed at lateral decubitus with the operation site up, the vertebrae were counted from cephalad to caudal direction until reaching T5 spinous process as the first palpable spinous process is C7. The ultrasound probe was placed vertically 3 cm lateral to the T5 spinous process. Three muscles were identified superficial to the hyperechoic transverse process shadow as follows: trapezius, rhomboid major, and erector spinae. The needle was introduced from superior to inferior direction in-plane until the tip lay deep to erector spinae muscle. | Procedure: Plane block<br>* Two different plane blocks to control post-mastectomy pain<br>* Other names: Block;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First time analgesia request | The first time the patient ask for analgesia to control postoperative pain | Postoperative up to 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total analgesic consumption | The total calculated analgesics that were administered to control post operative pain | Postoperative up to 24 hours | 
| visual analogue scale | A subjective method to measure pain, where 0=no pain and 10 = worst comprehensible pain | Every two hours for 24 hours postoperative |