Comparison between Preemptive Erector Spinae Plane Block Versus Serratus Anterior Plane Block on Postoperative Analgesia for Patients Undergoing Modified Radical Mastectomy: A Randomized Clinical Trial

Document Type : Original Article

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Anesthesia and Surgical ICU Department, Faculty of Medicine, Benha University, Benha, Egypt

Abstract

Background: Among the most commonly executed breast cancer surgical treatments, the modified radical mastectomy (MRM) is one of the most common. Significant discomfort is associated with MRM in the immediate postoperative phase.
The aim of The Work: Was to compare Ultrasound‐guided Erector Spinae Plane Block (USG-ESPB) and Ultrasound Guided Serratus Anterior Plane Block (USG-SAPB) analgesic properties in MRM patients with axillary lymph nodes clearance.
Methods: This prospective, randomized, double-blind clinical trial was conducted on 70 female cases with breast cancer, their age ranging from 18 to 70 years, who were enrolled in MRM. Participants were equally distributed into 2 groups: group I was assigned USG-ESPB and group II was assigned USG-SAPB. Preoperative evaluation of every patient encompassed a comprehensive laboratory analysis, which included a complete blood count and renal function tests, in addition to a general examination.
Results: The time of the 1st need of rescue analgesic was significantly delayed in group I compared to group II (340.1 ± 14.84 min. vs. 274.7 ± 9.16 min., P<0.001). Group I had significantly lower total dose of tramadol compared to group II (83.3 ± 42.01 vs. 128.6 ± 28.64), (P<0.001). Group I had significantly lower percentage of patients requiring postoperative rescue analgesia compared to group II (51.43% vs. 80%, P=0.023).
Conclusions: Our analysis demonstrated that USG-ESPB offers prolonged analgesia, lower total dose of postoperative rescue analgesia, , reduced pain scores and diminished postoperative analgesic needs in patients undergoing unilateral MRM with axillary lymph nodes clearance surgery as opposed to USG-SAPB.

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