Ultrasound guided serratus anterior plane block versus erector spinae plane block with bupivacaine plus dexmedetomidine for postoperative pain after mastectomy

Abstract

Background & objective: 40-60% of surgical patients experience severe postoperative pain. This study aims to look at serratus anterior plane block (SAPB) with erector spinae plane block (ESPB) with dexmedetomidine added to bupivacaine for the administration of intense agony after bosom a medical procedure.

Methodology: A randomized controlled trial involving 40 women over 20 years old booked for a medical procedure. Patients were divided into two groups: SAPB (received SAPB) and ESPB (received ESPB at T5). Blocks were performed after general sedation on the worked side with bupivacaine 0. 25% with 0.5 µg/kg dexmedetomidine in 30 mL.

Results: In comparison to the SAPB group, the ESPB group exhibited a delayed time to initial desire for salvage absence of pain (P < 0.001). In the first 24 hours, it consumed a much smaller amount of pethidine than the SAPB group (P = 0.011). At two, six, and twelve hours, the ESPB group numerical rating scale was significantly lower than the SAPB group (P < 0.05). At 45 and 60 min, the ESPB group pulse and mean blood vessel pressure were significantly lower than those of the SAPB group (P < 0.05). Postoperative queasiness and retching, bradycardia, and hypotension were unimportant between the two gatherings.

Conclusion: With dexmedetomidine added to bupivacaine, ESPB gives delayed absence of pain, lower torment scores and postoperative pain-relieving prerequisites, and better hemodynamics with practically no distinction in aftereffects compared to SAPB in in mastectomy patients.

Abbreviations: ESPB: Erector Spinae Plane Block, PONV: postoperative nausea and vomiting, SAPB: serratus anterior plane block.

Keywords: Serratus Anterior Plane; Erector Spinae Plane; Block; Dexmedetomidine; Bupivacaine; Mastectomy

Citation: Farhat HSR, Ezz HAA, Elsyed AAZ, Algyar MF. Ultrasound guided serratus anterior plane block versus erector spinae plane block with bupivacaine plus dexmedetomidine for postoperative pain after mastectomy. Anaesth. pain intensive care 2025;29(5):345-351. DOI: 10.35975/apic.v29i5.2872

Received: November 24, 2024; Revised: January 20, 2025; Accepted: February 05, 2025