Comparing Efficacy of Different Types Serratus Anterior Block for Thoracotomy

• Status: Recruiting
• Trial end date: 2023-09-10
• Target enrollment: 0
• Participant gender: All

Summary

We aim to compare efficacy and efficiency of serratus anterior block with bupivacaine alone to bupivacaine/magnesium and bupivacaine /nalbuphine in postoperative analgesia for thoracotomy surgery.

Objectives:

To compare bupivacaine alone, bupivacaine/magnesium and bupivacaine /nalbuphine in serratus anterior plane block for intraoperative and postoperative analgesia for thoracotomy surgery.

• The time for 1st rescue analgesia.

• Calculation of the opioid requirements; (the total intra-operative post-operative morphine consumption in first 24h postoperative).

• Assessment of pain score (VAS)- rest, VAS-movement, VAS-cough during post-operative 24hrs period.

Hypothesis:

We hypothesize that magnesium sulfate and nalbuphine can reduce acute postoperative pain and result in efficacious postoperative analgesia due to block of the lateral cutaneous branches of the intercostal nerves (T2 - T6) by diffusion across the inter-fascial planes.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Cairo University
• Treatments: Bupivacaine; Nalbuphine

Criteria

Inclusion Criteria:

• Elective thoracotomy or unplanned thoracotomy after failed thoracoscopic surgery

• Patient with American Society of Anesthesiology ASA I, II or III.

Exclusion Criteria:

1. Patient refusal

2. Contraindication for regional anesthesia

• Allergy from local anesthetics

• Bleeding diathesis (Bleeding tendency with prothrombin concentration PC less than 75 % or platelet count less than 50,000/µL.

• Use of anticoagulants, infection at the puncture site.

3. Presence of severe Chronic renal impairment or acute renal failure, decompensated liver disease, cardiac or psychiatric disorders, GIT ulcers, communication barriers, hearing deficit or high grades of visual deficit that interfere with consenting, VAS assessments, and delirium, or another cognitive dysfunction.

4. Patient intubated preoperatively.

5. Patient will not be extubated immediately postoperatively

6. Opioid tolerant patients.

7. Any contraindications of Magnesium infusion as hypovolemia or severe impaired ventricular systolic function.

8. Contraindication of acetaminophen and Diclofenac sodium administration.