Hyaluronidase versus Verapamil as Adjuvant in Serratus Anterior Block for Postoperative Pain after Radical Mastectomy: A Prospective Study

Authors

Wafiya Mahdy, Department of Anesthesia, Intensive Care & Pain Management, Faculty of Medicine, Menoufia University, Egypt.Follow
Amal G Safan, Department of Anesthesia, Intensive Care & Pain Management, Faculty of Medicine, Menoufia University, Egypt.
Tarek Elhennawy, Department of Anesthesia, Intensive Care & Pain Management, Faculty of Medicine, Menoufia University, Egypt.

Subject Area

Anesthesiology

Article Type

Original Study

Abstract

Objectives: The research’s objective is to compare the effectiveness of adding hyaluronidase or verapamil to bupivacaine in ultrasound guided serratus plane block regarding primarily to total time of analgesia. Secondary, to time to peak analgesic effect together with the 24-hour opioid consumption, and adverse effects.

Background: Acute postoperative pain after modified radical mastectomy (MRM) is a major challenge. Serratus anterior plane (SAPB) block is widely used that is relatively easy and safe procedure. Adjuvants are usually added to local anesthetics to increase their analgesic effect and duration.

Patients and methods: 84 cases were distributed randomly by closed envelope technique into two groups (n=42 in each group). Sonar guided serratus (SAPB) for all. Group (A) received verapamil 2.5 mg plus bupivacaine 0.25% in volume of 0.5 ml/ kg and group (B) hyaluronidase 300 IU plus bupivacaine 0.25% in volume of 0.5 ml/ kg.

Results: The period of the block among groups was in favored of group A (group A; 10.52 ± 1.09 h) vs (group B; 9.17 ± 1.29 h), P

Conclusion: Verapamil achieved factual prolongation with a narcotic sparing effect. On the other hand, adding hyaluronidase to bupivacaine promotes the onset of serratus anterior block.

Recommended Citation

Mahdy, Wafiya; Safan, Amal G; and Elhennawy, Tarek (2024) "Hyaluronidase versus Verapamil as Adjuvant in Serratus Anterior Block for Postoperative Pain after Radical Mastectomy: A Prospective Study," Menoufia Medical Journal: Vol. 37: Iss. 3, Article 2.
DOI: https://doi.org/10.59204/2314-6788.3271