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A Prospective Randomised Study to Assess the Analgesic Efficacy of Serratus Anterior Plane (SAP) Block for Modified Radical Mastectomy Under General Anaesthesia

OBJECTIVE: Breast cancer is the most common malignancy among women and often requires surgery for the removal of the tumour. Uncontrolled pain after breast surgeries is a common problem. Serratus anterior plane (SAP) block is a recently designed technique to block the lateral cutaneous branches of t...

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Autores principales: Bhan, Swati, Mishra, Seema, Gupta, Nishkarsh, Garg, Rakesh, Vig, Saurabh, Thulkar, Sanjay, Kumar, Rajeev, Bhatnagar, Sushma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Turkish Anaesthesiology and Intensive Care Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098724/
https://www.ncbi.nlm.nih.gov/pubmed/33997841
http://dx.doi.org/10.5152/TJAR.2020.13
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author Bhan, Swati
Mishra, Seema
Gupta, Nishkarsh
Garg, Rakesh
Vig, Saurabh
Thulkar, Sanjay
Kumar, Rajeev
Bhatnagar, Sushma
author_facet Bhan, Swati
Mishra, Seema
Gupta, Nishkarsh
Garg, Rakesh
Vig, Saurabh
Thulkar, Sanjay
Kumar, Rajeev
Bhatnagar, Sushma
author_sort Bhan, Swati
collection PubMed
description OBJECTIVE: Breast cancer is the most common malignancy among women and often requires surgery for the removal of the tumour. Uncontrolled pain after breast surgeries is a common problem. Serratus anterior plane (SAP) block is a recently designed technique to block the lateral cutaneous branches of the ventral rami of thoracic intercostal nerves and may cover the area of surgical dissection for modified radical mastectomy (MRM). The primary objective of this study was to evaluate the effect of SAP block on the time to first rescue analgesic in the post-operative period in patients undergoing MRM. METHODS: A randomised, single-blind, parallel group trial was conducted in a single teaching hospital. A total of 100 patients undergoing MRM were randomised in a 1:1 ratio into 2 groups: MRM under general anaesthesia (GA) alone (group G, n=50) or GA with SAP block (group S, n=50). Blocks were performed under ultrasound guidance at the level of the 5(th) rib in the midaxillary line with 0.4 mL kg(−1) of 0.375% ropivacaine. RESULTS: The time to request of first rescue analgesia was significantly prolonged in group S compared with group G (p=0.008). Median (interquartile range) for time to rescue analgesia in group S was 120 (60–300) min, whereas in group G, it was 60 (15–120) min. Post-operative pain scores and the number of patients requiring intra-operative additional fentanyl were significantly less in group S. No technique-related adverse events were observed. CONCLUSION: SAP block improved perioperative analgesia in patients undergoing MRM. CLINICAL TRIAL REGISTRY NUMBER: CTRI/2017/11/010424. (http://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=45912.14862)
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spelling pubmed-80987242021-05-13 A Prospective Randomised Study to Assess the Analgesic Efficacy of Serratus Anterior Plane (SAP) Block for Modified Radical Mastectomy Under General Anaesthesia Bhan, Swati Mishra, Seema Gupta, Nishkarsh Garg, Rakesh Vig, Saurabh Thulkar, Sanjay Kumar, Rajeev Bhatnagar, Sushma Turk J Anaesthesiol Reanim Original Article OBJECTIVE: Breast cancer is the most common malignancy among women and often requires surgery for the removal of the tumour. Uncontrolled pain after breast surgeries is a common problem. Serratus anterior plane (SAP) block is a recently designed technique to block the lateral cutaneous branches of the ventral rami of thoracic intercostal nerves and may cover the area of surgical dissection for modified radical mastectomy (MRM). The primary objective of this study was to evaluate the effect of SAP block on the time to first rescue analgesic in the post-operative period in patients undergoing MRM. METHODS: A randomised, single-blind, parallel group trial was conducted in a single teaching hospital. A total of 100 patients undergoing MRM were randomised in a 1:1 ratio into 2 groups: MRM under general anaesthesia (GA) alone (group G, n=50) or GA with SAP block (group S, n=50). Blocks were performed under ultrasound guidance at the level of the 5(th) rib in the midaxillary line with 0.4 mL kg(−1) of 0.375% ropivacaine. RESULTS: The time to request of first rescue analgesia was significantly prolonged in group S compared with group G (p=0.008). Median (interquartile range) for time to rescue analgesia in group S was 120 (60–300) min, whereas in group G, it was 60 (15–120) min. Post-operative pain scores and the number of patients requiring intra-operative additional fentanyl were significantly less in group S. No technique-related adverse events were observed. CONCLUSION: SAP block improved perioperative analgesia in patients undergoing MRM. CLINICAL TRIAL REGISTRY NUMBER: CTRI/2017/11/010424. (http://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=45912.14862) Turkish Anaesthesiology and Intensive Care Society 2021-04 2020-11-30 /pmc/articles/PMC8098724/ /pubmed/33997841 http://dx.doi.org/10.5152/TJAR.2020.13 Text en © Copyright 2021 by Turkish Anaesthesiology and Intensive Care Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Original Article
Bhan, Swati
Mishra, Seema
Gupta, Nishkarsh
Garg, Rakesh
Vig, Saurabh
Thulkar, Sanjay
Kumar, Rajeev
Bhatnagar, Sushma
A Prospective Randomised Study to Assess the Analgesic Efficacy of Serratus Anterior Plane (SAP) Block for Modified Radical Mastectomy Under General Anaesthesia
title A Prospective Randomised Study to Assess the Analgesic Efficacy of Serratus Anterior Plane (SAP) Block for Modified Radical Mastectomy Under General Anaesthesia
title_full A Prospective Randomised Study to Assess the Analgesic Efficacy of Serratus Anterior Plane (SAP) Block for Modified Radical Mastectomy Under General Anaesthesia
title_fullStr A Prospective Randomised Study to Assess the Analgesic Efficacy of Serratus Anterior Plane (SAP) Block for Modified Radical Mastectomy Under General Anaesthesia
title_full_unstemmed A Prospective Randomised Study to Assess the Analgesic Efficacy of Serratus Anterior Plane (SAP) Block for Modified Radical Mastectomy Under General Anaesthesia
title_short A Prospective Randomised Study to Assess the Analgesic Efficacy of Serratus Anterior Plane (SAP) Block for Modified Radical Mastectomy Under General Anaesthesia
title_sort prospective randomised study to assess the analgesic efficacy of serratus anterior plane (sap) block for modified radical mastectomy under general anaesthesia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098724/
https://www.ncbi.nlm.nih.gov/pubmed/33997841
http://dx.doi.org/10.5152/TJAR.2020.13
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