Breast Cancer Clinical Trial
Official title:
Efficacy of Adding Tramadol as Adjunctive Analgesic With Levobupivacaine in Modified Pectoral Nerve Block for Modified Radical Mastectomy Surgery
The aim of this study is to evaluate the addition of tramadol combined with levobupivacaine in the reduction of postoperative pain, postoperative opioid consumption after modified radical mastectomy surgery.
Breast surgeries are usually associated with sever postoperative pain ,good perioperative
analgesic technique after breast surgery is always questionable Thoracic epidural and
paravertebral blocks became the gold standard techniques for pain relief, however they may be
associated with complications such as spinal cord injury, total spinal anesthesia
,inadvertent intravascular injection and pneumothorax.
Pecs block is less invasive procedure involving ultrasound guided inter-fascial injections
which has been suggested as potential alternative analgesic technique.
The block produces excellent analgesia and can be used as a rescue block in cases where the
analgesia provided by the paravertebral or epidural was patchy or ineffective .
Different drugs, including opioids, non-steroidal anti-inflammatory drugs, ketamine,
clonidine, and neostigmine, have been added to local anesthetics to improve the duration and
quality of analgesia.Tramadol has also been used for pain management of patients.
The power of this clinical trial was prospectively calculated using the G Power analysis
program. Using a priory power analysis with accuracy mode calculations with visual analogue
score (VAS) as the primary variant and assuming type I error protection of 0.05 and an effect
size convention of 0.9, a total sample size of 54 patients (27 patients in each group)
produced a power of 0.90. To protect against drop out cases we added 6 cases to the total
number (total of 60 cases)
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