After Breast Surgery Clinical Trial
Official title:
Stellate Ganglionic Block Versus Combined Stellate Ganglionic Block and Modified Pectoral Nerve Block in Treatment of Post Mastectomy Pain Syndrome.
Post mastectomy pain syndrome result from surgical damage to the intercostobrachial nerve,
the lateral cutaneous branch of the second intercostal nerve that is often resected at
mastectomy. result from surgical damage to the intercostobrachial nerve, the lateral
cutaneous branch of the second intercostal nerve that is often resected at mastectomy, A
second version of the pectoral nerve block is described, called ''modified Pecs block'' or
Pecs block type II.
This novel approach aims to block at least the pectoral nerves, the intercostobrachial,
intercostals III-IV-V-VI and the long thoracic nerve. These nerves need to be blocked to
provide complete analgesia during breast surgery
The aim of this study is to evaluate the efficacy of ultrasound guided stellate ganglionic
block alone versus stellate ganglionic block plus pecs II block in management of chronic
postmastectomy pain ,patient will be trained to use visaual analog scale to describe their
pain range of movement will be assessed using manual geniometry at post procedure visits at
one month ,3 months and 6 months procedures in each group will done using ultrasound
guidance mixture will be used.
All patients will be informed about the procedure and its possible consequences after
detailed explanation of protocol of this study. Written informed consents will be obtained
before the procedure.
With each block, an intravenous cannula will be inserted and secured. All suitable
resuscitation equipment and drugs will be available. Vital signs (heart rate, blood
pressure, and oxygen saturation) will be monitored throughout the procedure and up to 1 hour
after the block performance. Midazolam 0.02 ug/kg will be administered intravenously as
premedication.
Brief evaluation will be done for all patients with regard to their systemic diseases,
general condition, and coagulation status.
All patients will be familiar with the use of 10-cm visual analogue scale score (VAS)
identifying 0 as no pain and 10 as worst imaginable pain.Basal assessment of range of
movement for abduction ,external rotation ,and forward flextion using manual geniometry and
patients will be asked to complete Quality of life questionnaire
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Supportive Care