Clinical trial NCT05176938: Effect of Ultrasound Guided Thoracic Interfascial Plane Block Versus Erector Spinae Plane Block After Mastectomy
Official title: Effect of Preoperative Ultrasound Guided Thoracic Interfascial Plane Block Versus Preoperative Thoracic Erector Spinae Plane Block on Acute and Chronic Pain After Modified Radical Mastectomy
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Pain, Acute
Erector Spinae Plane Block
Mastectomy, Modified Radical
Thoracic Interfascial Plane Block
Pain, Chronic
Lead sponsor: Tanta University
Sponsor class: OTHER
First posted: 2022-01-04
Enrollment: 90
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study will be conducted to compare the efficacy of ultrasound guided thoracic interfascial plane block versus ultrasound guided erector spinae plane block on acute and chronic pain after modified radical mastectomy surgery.

Detailed description: Various thoracic nerve blocks performed for pain control after breast cancer surgery provide superior analgesic effect and reduce postoperative nausea and vomiting as a result of the decreased use of opioid analgesics.

Ultrasound-guided erector spinae block (ESB) is a regional anesthesia technique; recently described by Forero et al, in management of thoracic neuropathic pain. It became popular because it is much safer and easily administered than other alternative regional techniques as paravertebral and thoracic epidural block.

ESB leads to effective postoperative analgesia when performed at T 4-5 level for breast and thoracic surgery, and T 7 level for abdominal surgeries. Spread of local anesthetic following ESB in the cephalic and caudal directions can lead to analgesia from C7 to L2-3.

There have been several reports that thoracic interfascial plane block is useful for multimodal analgesia in patients undergoing mastectomy, Thoracic interfascial plane block including pecto-intercostal fascial plane block (PIFB) and serratus intercostal fascial plane block (SIFB).

Thoracic interfascial plane block is the peripheral nerve block that targets the intercostal nerves branches distributed in the chest and axilla, Although PIFB and SIFB are thought to be relatively easy to perform there have been no reports of the simultaneous performance of the two blocks.

Eligibility criteria: Inclusion Criteria:

* Female patients admitted for modified radical mastectomy surgery.
* American Society of Anesthesiologists (ASA) physical activity I, II
* Aged (18 - 65) years

Exclusion Criteria:

* Patient refusal.
* Patient with neurological deficit.
* Patient with bleeding disorders (coagulopathy, thrombocytopenia anticoagulant, and antiplatelet drugs).
* Uncooperative patient.
* Infection at the block injection site.
* Patients with a history of allergy to drugs.

Primary outcomes:
measure: Total analgesics consumption in the first 24h after surgery.
timeFrame: 24 hours postoperative
Secondary outcomes:
measure: Time to first analgesic request after surgery
timeFrame: 24 hours Postoperative
measure: Visual Analogue score (VAS)
timeFrame: 24 hours Postoperative
measure: Complications occurrence (hypotension, pneumothorax, bradycardia)
timeFrame: 24 hours Postoperative
Other outcomes:
Locations:
Study officials:
References: