Ultrasound-guided serratus anterior block versus instillation of local anaesthetic through surgical drain in modified radical mastectomy: A randomized controlled study

Abstract

ABSTRACT Background The primary outcome measure of this study was to compare ultrasound-guided serratus anterior block versus instillation of local anesthetic through the surgical drain in modified radical mastectomy patients as regards the duration of analgesia between the two techniques. Material and methods This prospective, randomized, double-blinded study was conducted on 162 female patients aged 25–50 years, ASA 1, ASA 2, selected for elective unilateral modified radical mastectomy in the Main University Hospital. Group SABP (n = 81) received 20 ml bupivacaine 0.5% in the plan between serratus anterior and latissimus dorsi muscles. Group LA (n = 81) received 40 ml bupivacaine 0.25%, 20 ml in each surgical drain (axillary and chest wall drain). Results The results of the study revealed that the duration of analgesia lasted for 20.8 hr in the SAPB group, while it was 8.14 hourshr in the LA group (P-value ˂0.001). In most postoperative periods, the SAPB group had lower VAS scores at rest and with movement of the ipsilateral arm compared to the LA group. The overall dose and frequency of the consumed rescue analgesic over the first 24 hr in the postoperative period were significantly lower in the SAPB group than in the second group (P-value <0.001). The SAPB group had higher satisfaction scores than the LA group (P-value <0.001). Conclusion It was concluded that the SAPB technique showed superiority over the anesthetic instillation method in controlling acute post-mastectomy pain with a longer duration of analgesia, more patient satisfaction, and less rescue analgesics were consumed.