Modified Versus Conventional Serratus Anterior Plane Block

Zagazig University

Status: Enrolling

Conditions: Postoperative Pain, Acute

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

Study type: Interventional

Funder types: Other

Identifiers

NCT05661253

ZU-IRB # 10061

Details and patient eligibility

About

comparing preemptive analgesia with ultrasound guided modified serratus anterior plane block versus ultrasound guided serratus anterior plane block

Full description

comparing the quality of postoperative analgesia and opioid consumption in patients undergoing Video-Assisted Thoracoscopic Surgery when using preemptive analgesia with ultrasound guided modified serratus anterior plane block versus ultrasound guided serratus anterior plane block

Enrollment: 99 estimated patients

Sex: All

Ages: 21 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patient consent.
• both sex.
• Age: 21-70 years old.
• BMI: 18- 30 kg/m2
• ASA: I and II.
• Scheduled for elective unilateral Video-Assisted thoracoscopy under general anesthesia.

Exclusion criteria

• History of allergy to the local anesthesia agents used in this study,
• Skin lesion at needle insertion site,
• Those receiving anticoagulant therapy or having bleeding disorders
• Patients with history of chronic pain and taking analgesics,
• Patients with sepsis and Significant cardiac, liver or renal diseases
• Uncooperative patients or with psychiatric disorders.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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99 participants in 3 patient groups

Control group

No Intervention group

Description:

will take general anesthesia without nerve block

SAP block group

Active Comparator group

Description:

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. .

Treatment:

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

modified SAP block group

Active Comparator group

Description:

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 .

Treatment:

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