Comparing Efficacy of Different Drugs Combinations for Serratus Anterior Block for Thoracotomy

Summary

We aim to compare efficacy and efficiency of serratus anterior block with bupivacaine alone to bupivacaine/magnesium and bupivacaine /nalbuphine in postoperative analgesia for thoracotomy surgery. Objectives: To compare bupivacaine alone, bupivacaine/magnesium and bupivacaine /nalbuphine in serratus anterior plane block for intraoperative and postoperative analgesia for thoracotomy surgery. * The time for 1st rescue analgesia. * Calculation of the opioid requirements; (the total intra-operative post-operative morphine consumption in first 24h postoperative). * Assessment of pain score (VAS)- rest, VAS-movement, VAS-cough during post-operative 24hrs period. Hypothesis: We hypothesize that magnesium sulfate and nalbuphine can reduce acute postoperative pain and result in efficacious postoperative analgesia due to block of the lateral cutaneous branches of the intercostal nerves (T2 - T6) by diffusion across the inter-fascial planes.

Timeline

Start

2022-12-09

Primary completion

2023-09-10

Completion

2023-11-10

Publications

• Background Gerner P. Postthoracotomy pain management problems. Anesthesiol Clin. 2008 Jun;26(2):355-67, vii. doi: 10.1016/j.anclin.2008.01.007.
• Background Kavanagh BP, Katz J, Sandler AN. Pain control after thoracic surgery. A review of current techniques. Anesthesiology. 1994 Sep;81(3):737-59. doi: 10.1097/00000542-199409000-00028. No abstract available.
• Background Katz J, Jackson M, Kavanagh BP, Sandler AN. Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin J Pain. 1996 Mar;12(1):50-5. doi: 10.1097/00002508-199603000-00009.
• Background Kaushal B, Chauhan S, Saini K, Bhoi D, Bisoi AK, Sangdup T, Khan MA. Comparison of the Efficacy of Ultrasound-Guided Serratus Anterior Plane Block, Pectoral Nerves II Block, and Intercostal Nerve Block for the Management of Postoperative Thoracotomy Pain After Pediatric Cardiac Surgery. J Cardiothorac Vasc Anesth. 2019 Feb;33(2):418-425. doi: 10.1053/j.jvca.2018.08.209. Epub 2018 Aug 31.
• Background Semyonov M, Fedorina E, Grinshpun J, Dubilet M, Refaely Y, Ruderman L, Koyfman L, Friger M, Zlotnik A, Klein M, Brotfain E. Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery. J Pain Res. 2019 Mar 11;12:953-960. doi: 10.2147/JPR.S191263. eCollection 2019.
• Background De Oliveira GS Jr, Castro-Alves LJ, Khan JH, McCarthy RJ. Perioperative systemic magnesium to minimize postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2013 Jul;119(1):178-90. doi: 10.1097/ALN.0b013e318297630d.
• Background Chawda PM, Pareek MK, Mehta KD. Effect of nalbuphine on haemodynamic response to orotracheal intubation. J Anaesthesiol Clin Pharmacol. 2010 Oct;26(4):458-60.

Drugs

Indications

No indication recorded.