Pain, Postoperative
Conditions
Keywords
Erector Spinae Block, magnesium sulphate, dexmedetomidine
Brief summary
To compare the analgesic efficacy of dexmedetomidine and magnesium sulphate as adjuvants to levobupivacaine in erector spinae plane block in modified radical mastectomy surgery for acute and chronic pain management.
Detailed description
3 groups. Group (C) / (I):20 patient (control group) : Patients will receive 20 ml 0.25% levobupivacaine into the interfascial plane below erector spinae muscle at level of T5. Group (D)/ (II) :20 patient (Dexmetonidine group) : Patient will receive 20ml 0.25% levobupivacaineas above + 1μ/kg dexmedetomidine. Group (M) / (III) : 20 patient (magnesium slphate group) : Patient will receive 20ml 0.25% levobupivacaineas above + 0.7 mg/kg MgSo4 . The patient, the anesthesiologist who administered the drugs, and the data collector will be blinded to the study drugs.
Interventions
PROCEDUREultrasound guided erector spinae plan block using bupivacaine for modified radical mastectomy
Ultrasound guided Erector spinae plane (ESP) block will be given with patient in sitting position depending on surgical site (left or right) ESP block will be given using high frequency linear u/s transducer, the probe is placed in longitudinal orientation lateral to thoracic fifth spinous process, then Trapezius muscle, Rhomboidus major muscle, and erector spinae muscle
PROCEDUREultrasound guided erector spinae plan block with bupivacaine and Dexmetonidine for modified radical mastectomy
Ultrasound guided Erector spinae plane (ESP) block will be given with patient in sitting position depending on surgical site (left or right) ESP block will be given using high frequency linear u/s transducer, the probe is placed in longitudinal orientation lateral to thoracic fifth spinous process, then Trapezius muscle, Rhomboidus major muscle, and erector spinae muscle
PROCEDUREultrasound guided erector spinae plan block with bupivacaine and magnesium slphate for modified radical mastectomy
Ultrasound guided Erector spinae plane (ESP) block will be given with patient in sitting position depending on surgical site (left or right) ESP block will be given using high frequency linear u/s transducer, the probe is placed in longitudinal orientation lateral to thoracic fifth spinous process, then Trapezius muscle, Rhomboidus major muscle, and erector spinae muscle
Sponsors
South Egypt Cancer Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
25 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
* female patient * American society of anesthesiologists (ASA) I and II physical status * age from 25 to 70 years old * scheduled for either left or right modified radical mastectomy (MRM).
Exclusion criteria
* infection of the skin at or near site of needle puncture * coagulopathy * drug hypersensitivity or allergy to the studied drugs * central or peripheral neuropathy * significant organ dysfunction cardiac dysrrhythmias * obesity (BMI\>35kg/m2) * recently use analgesic drugs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| analgesia requirement | 24 hours | first request for analgesia and total analgesia requirements |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| chronic pain assessment | 6 months | Assessment of chronic pain at 1-3 and 6 month post-operatively using LANSS pain score. a score of 12 or more is suggestive of neuropathic pain. |
Countries
Egypt
Outcome results
None listed