Modified Versus Conventional Serratus Anterior Plane Block

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• Pain, Postoperative 5,093

Pain, Postoperative

5,093 studies on the registry are indexed under Pain, Postoperative; 1,140 are open to participants now.

This study's planned enrollment of 99 is above the median of 75 across 4,344 interventional studies indexed under Pain, Postoperative.

Lead sponsor

Zagazig University is the lead sponsor of 447 studies on the registry; 75 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Study arms

• No intervention
  Control group

  will take general anesthesia without nerve block

• Active comparator
  SAP block group

  After sterilization of the skin and draping, the high frequency linear probe of Sonosite M Turbo ultrasonography (FUJIFIM sonosite, Inc., Bothell, WA, USA) will be placed at the level of the midclavicular line in a sagittal plane. The second rib will be recognized at the axillary artery. The probe will be moved downward to count the ribs until the level of the fifth rib in the mid-axillary line. At this time, the latissimus dorsi muscle (lying superficial) and the serratus anterior muscle (lying deep) will be clearly visualized under ultrasound . Next, A 22-gauge, 80 mm needle (Stimuplex D, B-Braun, Germany) will be inserted in plane relative to the ultrasound probe between the latissimus dorsi and the serratus anterior muscle. After confirming negative aspiration of blood, 1 ml normal saline will be injected for hydro-dissection sign to verify the needle tip, then a volume of 25 ml 0.25% bupivacaine will be injected superficially to serratus anterior muscle. .

  Drug: 25 ml of bupivacaine 0.25% via serratus anterior block

• Active comparator
  modified SAP block group

  The patient will be placed in the lateral decubitus position according to the selected site of surgical intervention. After sterilization of the skin and draping, the high frequency linear probe of Sonosite M Turbo ultrasonography ( FUJIFIM sonosite, Inc., Bothell, WA, USA) will be placed horizontally midway between tip of the scapula and posterior axillary line to identify the view of latissimus dorsi(lying superficial) and serratus anterior muscle(lying deep) over either the sixth or seventh rib. A 22-gauge, 80 mm needle (Stimuplex D, B-Braun, Germany) will be inserted in plane relative to the ultrasound probe from posteromedial to anterolateral direction toward posterior axillary line till reaching the interfacial plane between latissimus dorsi and serratus anterior muscle . After confirming negative aspiration of blood, 1 ml normal saline will be injected for hydro-dissection sign to verify the needle tip, then a volume of 25 ml 0.25% bupivacaine will be injected .

  Drug: 25 ml of bupivacaine 0.25% via modified serratus anterior palne block

Interventions

• Drug25 ml of bupivacaine 0.25% via serratus anterior block

  patients will receive conventional serratus anterior plane block with a volume of 25 ml of bupivacaine 0.25% followed by induction of general anesthesia,

• Drug25 ml of bupivacaine 0.25% via modified serratus anterior palne block

  patients will receive modified serratus anterior plane block with a volume of 25 ml of bupivacaine 0.25% followed by induction of general anesthesia.

Primary outcomes

1. tramadol consumption

   The amount of tramadol consumption at 24

   Time frame: at 24 hours postoperative

Secondary outcomes

1. Time of performance

   Time of performance of block defined as time from ultrasound probe positioning till the end of the block procedure

   Time frame: from ultrasound probe positioning till the end of the block procedure

2. Time to first dose of rescue analgesia

   Time to first dose of rescue analgesia (VAS \> 3) after surgery

   Time frame: during the first postoperative 24 hours

3. Patient satisfaction

   Patient satisfaction with analgesia in the first 24hours postoperative hours will be Likert scale where 5 is very satisfied and 0 is very dissatisfied.

   Time frame: at 24 hous post operative

Individual participant data

Plan to share: No