الفهرس | Only 14 pages are availabe for public view |
Abstract It has been observed that the majority of patients who had (MRM) surgery suffered severe acute pain following surgery. Inadequate pain control has both psychological and physiological consequences. Thus, post-operative pain control of MRM surgery is critical in perioperative anesthetic care. The Study aim: Primary outcome: to compare the ESPB efficacy versus posterior SAPB approach as regards control of postoperative pain in MRM by using the VAS during rest and movement. Secondary outcomes: To compare total opioid consumption ,sensory level ,axillary coverage and hemodynamic changes in the first 24 hours postoperatively. To compare the patient satisfaction before discharge from the hospital in both groups and local or systemic complications. Neuropathic pain will be assessed after one week and one moth postoperatively. The study began on June 1, 2020-2021 on 56 patients aged 20-60 years old (ASA-II) scheduled for MRM at the MRI Hospital; Alexandria University after acquiring authorization from the Medical Research Institute (MRI) Ethical Committee and obtaining signed informed consent from each patient. Patients will be randomly assigned to one of two groups. group I: SAPB (posterior approach): 28 female patients were blocked with the administration 20 mL of 0.25% bupivacaine and 8 mg dexamethasone. group II: ESPB: 28 female patients were blocked with the administration of 20 ml of 0.25% bupivacaine and 8 mg dexamethasone. A randomized controlled trial (RCT) is used in this investigation. Findings: Demographic features (age, weight, height and BMI) showed no significant difference statistically (p= 0.321, p=0.191, p=0.311 and p=0.663 respectively). HR and the MABP before and twenty minutes after injection and intraoperatively and postoperatively together with postoperative oxygen saturations percentage changes, total opioid consumption, neuropathic pain, VAS, postoperative shoulder pain, patient satisfaction and recorded complications showed a difference with no significance statistically between both involved groups. ESPB showed an increase with statistical significance in the sensory level (number of dermatomes) (p= 0.031). |