Background: Women undergoing mastectomy surgery often experience severe post-operative pain and may develop into chronic pain.
Objective: current study compared the efficacy and safety of ultrasound-guided serratus anterior plane block (SAPB) with thoracic paravertebral block (TPVB) for controlling acute post-mastectomy pain.
Patients and Methods: This prospective study was conducted on 60 female patients undergoing mastectomy surgery. Patients were randomized into two groups: (TPVB) group (n=30): patients received paravertebral block at T4 with 20ml of bupivacaine 0.25% and adrenalin 5ug/ml and (SAPB) group (n=30): patients received serratus intercostal plane block with 0.4ml/kg bupivacaine 0.25% plus adrenalin 5ug/ml. Both performed as single injection at the end of surgery. Postoperative VAS pain scores, time to first analgesic requirement, total dose of rescue analgesic, hemodynamic parameters and incidence of postoperative nausea and vomiting were all recorded.
Results: VAS scores were significantly lower in SAPB group compared with TPVB group at 12th and 16th hour postoperative. Total dose of rescue analgesic was significantly lower in SAPB compared with TPVB. Time to the first analgesic dose was significantly longer in SAPB compared to TPVB. No significant difference between the study groups regarding the hemodynamic parameters and incidence of postoperative nausea and vomiting.
Conclusion: Both SAPB and TPVB provide adequate analgesia for breast surgeries but current study found that SAPB superior to TPVB in terms of delayed requirement for the first rescue analgesia & 24 hours reduced analgesic consumption, indicating that SAPB is a feasible and effective method for pain treatment after breast surgery. |
