Effectiveness of Combined Erector Spinae and Pecto-intercostal Fascial Plane Blocks Versus Thoracic Paravertebral Block in Perioperative Pain in Modified Radical Mastectomy

• Status: Active, not recruiting
• Trial end date: 2021-09-01
• Target enrollment: 0
• Participant gender: Female

Summary

Erector spinae plane block (ESPB) is a new evolving fascial pain block in the era of regional anaesthesia. ESPB was applied in varieties of surgeries and provided an eminent role in trauma patient especially those with fracture ribs. ESPB exhibits simple, safe and easy technique with minimal or no sympathetic blockade effects, thus gaining popularity in wide range of surgeries. The optimum effective dose of local anaesthetic, the effective volume of drug used for desired dermatomes. Comparison with different regional blocks is preferable to know the optimum analgesic technique for those population of patients (4). Many studies have already compared solo ESPB with thoracic epidural analgesia (TEA), thoracic paravertebral block (TPVB), serratus anterior plane block (SAPB) and pectoral nerves block. Only few case reports described the combination effect of rhomboid intercostal, transversus thoracic muscle and parasternal plane blocks to ESPB in modified radical mastectomy.

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

Details

• Lead Sponsor: Kasr El Aini Hospital
• Treatments: Bupivacaine; Dexamethasone; Dexamethasone 21-phosphate

Criteria

Inclusion Criteria:

• • 18-60 years of age

• ASA I-II

• Elective unilateral modified radical mastectomy with axillary lymph node dissection

• Body weight (50-90 kg)

Exclusion Criteria:

• • Patient refusal

• Known allergy to any of the study drugs

• Bleeding disorders (platelets < 50 000, PC <60%, INR>1.5)

• Infection at the site of needle puncture or sepsis

• Obesity (BMI > 30 kg/m2)

• Chronic opioid user eg; morphine addict

• Chronic pain disease eg certain cancer patients, rheumatological disease

• Inability to comprehend or use the numeric rating pain scoring system

• Psychiatric illness eg, psychiatric patients on hypnotic treatment