الفهرس 
ANATOMY OF THE BREASTOnly 14 pages are availabe for public view
 |  | from | 98 |  |  |
| | | from | 98 | | |
Abstract
Pain control after breast surgeries is crucial as poor pain control can lead to a variety of undesirable consequences, as; patient’s suffering, difficulty in breathing that can lead to respiratory complications, prolonged hospital stay and the patient might end up with chronic pain.
Postoperative pain control regime needs to be safe, effective and with minimal side effects.
In the clinical practice there are many ways to provide analgesia after breast surgeries. Different nerve blocks can be used. Examples of the commonly used blocks are the thoracic epidural nerve block and thoracic paravertebral block; they provide excellent pain relief, but; they are difficult to perform, and could be associated with some complications such as pneumothorax, hemodynamic instability or some neurological complications. Therefore, serratus anterior plane block has emerged as a pain control method in individuals undergoing breast surgery because it is not difficult to perform, and is not associated with such serious complications.
The aim of this study is to compare the effect of ultra-sound guided serratus anterior plane block versus conventional IV analgesics in postoperative pain management in modified radical mastectomy.
The study was conducted on 40 randomly chosen patients at Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 20 patients each.
The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system in the first 24 hours postoperatively and the time to the first rescue analgesic and the total dose of Pethidine needed postoperatively and these were our primary outcome, we also recorded the total dose of Ketorlac consumed by the patients postoperatively, the patients’ satisfaction using verbal one to ten scale and the incidence of nausea or vomiting were recorded and compared to achieve our secondary outcome of the study which included reducing opioid requirement and avoiding their side effects.
The results of our study were in favor of the serratus anterior plane block, as we have found that the timing to the first rescue analgesic was significantly longer, the VAS scoring and the total dose of pethidine needed postoperatively were significantly less in the SABP group, also; we found that the incidence of post-operative nausea and vomiting was significantly less in the SABP group compared to the control group as well.
So, in a nutshell, the present study has found that the serratus anterior plane block can be used as one of the modalities in managing the pain of patients undergoing MRM surgery. This procedure was effective in reducing the need for postoperative opioids usage, with fewer side effects.