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Ultrasound Guided PECs II (Pectoralis and Serratus Nerves) Block in Patients Undergoing a Thoracic Surgery (NCT03023982)

A new conceptual regional anesthesia the PECs II block (modified pectoral and serratus nerves block) has been described for pain control after thoracic surgery, one of the indications to perform this method is analgesia for surgeries or procedures involving lateral chest wall
  • Drug: Bupivacaine Hydrochloride
    40 cc 0.25% of Bupivacaine Hydrochloride injection using ultrasound approach will be administered between pectoralis minor and serratus anterior muscle at the 3rd and 4th rib
    • Marcaine
  • Device: Ultrasound
    All blocks will be done under ultrasound
    • Sonosite
  • Procedure: Thoracotomy
    The patient population will include patients that undergo either open thoracotomy or thoracoscopy for anatomic and non-anatomic lung resection. The standard thoracoscopy approach in our institute includes three holes technic. There are two incisions of 1 cm and utility incision of 4 cm. The standard thoracotomy is posterior- lateral thoracotomy which divided the latissimus dorsi muscle but spears the serratus anterior muscle.
    • Drug: Opioids
      standard pain control with opioids
      • Morphine
    • Drug: NSAID
      standard pain control with NSAIDs
      • Perfalgan
    Ages eligible for Study
    18 Years and older
    Genders eligible for Study
    All
    Accepts Healthy Volunteers
    No
    Inclusion Criteria:
    • All patients undergoing thoracic surgery, older ≥18 years
    • Patients who meet criteria of ASA I-II-III class.
    Exclusion Criteria:
    • Patients who will be unconscious or mentally incompetent
    • Patients refusal to participate in the study
    • ASA -IV -V
    • Patient with coagulopathy
    • Hemodynamically unstable (systolic BP < 90, HR > 100)
    • Allergy to local anesthetic drugs or opioids
    • Pregnant patient
    • History of opioid abuse
    The PECs I block was found to be very effective after breast cancer surgery and sub-pectoral prosthesis for pain control management.

    This block is provided by injection into another myofascial plane, this time between pectoralis minor and serratus anterior muscle at the level of 3rd and 4th rib.PECs II block is simple in performance with a high success rate and minimal incidence of complications, especially, if used ultrasound approach that gives a good understanding of anatomy of the lateral thoracic wall.

    In present clinical trial we are going to compare PECs block for pain control with traditional pain management techniques based on IV opioids and NSAIDs treatment in patient undergoing thoracic surgery in early postoperative period.
    Status:
    not yet recruiting
    Type:
    Interventional
    Phase:
    Start:
    31 January, 2017
    Updated:
    16 January, 2017
    Participants:
    168
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