Paravertebral Block Versus Erector Spinae Plane Block for Modified Radical Mastectomy in Womens.
Pain, Postoperative, Pulmonary Atelectasis, Mastectomy
About this trial
This is an interventional prevention trial for Pain, Postoperative focused on measuring Paravertebral block, Erector spinae plane block, Modified radical mastectomy, respirometer
Eligibility Criteria
Inclusion Criteria:
- ASA grade II-III.
- female patients in the age group of 18-50 yr.
- undergoing modified radical mastectomy under general anesthesia.
- BMI <40 kg.m2.
Exclusion Criteria:
- pre-existing infection at the block site.
- Coagulopathy.
- morbid obesity (BMI >40 kg m-2).
- allergy to local anesthetics.
- decreased pulmonary reserve.
- major cardiac disorders.
- renal dysfunction.
- pre-existing neurological deficits.
- psychiatric illness.
Sites / Locations
- Assiut UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Paravertebral plane block group
Erector spinae plane block group
The TPVB will be administered at the T4 level with the patient in the sitting position.The ultrasound probe will be placed 5 cm from the midline in the craniocaudal direction and moved medially to identify the transverse process and parietal pleura. The superior costotransverse ligament was identified as a collection of homogeneous linear echogenic bands alternating with echo-poor areas running from one transverse process to the next. Bubivacaine0.5%, 20 ml will be deposited in the space between the pleura and the costotransverse ligament.
the transducer will be placed in a transverse orientation to identify the spinous process, lamina,and transverse process.The tip of the transverse process will be centered on the ultrasound screen, and the transducer will be rotated 90 degrees into a longitudinal orientation to obtain a parasagittal view. Depending on the level imaged, 2 or 3 hypoechoic muscle layers were identified overlying the tip of the transverse processes. From T1 to T5 the erector spinae, rhomboid major and trapezius muscles are visible posterior and superfacial to the transverse processes. An 8cm 22-gauge block needle will be Inserted in-plane to the ultrasound beam in a cephalad-to-caudad Direction to place the needle tip between the posterior fascia of Erector spinae and the tip of the targeted transverse process.following which a total of 20 mL of 0.5%bupivacaine will be injected.