The Effect Of Ultrasound-guided Modified Pectoral Nerves Block Versus Ketamine Plus Magnesium Infusion On Analgesic Profile In Breast Cancer Surgeries

NCT ID: NCT04095455

Last Updated: 2020-10-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-12

Study Completion Date

2021-04-15

Brief Summary

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Background: Postoperative pain is one of the greatest patient concerns following surgery. However, general anesthesia cannot provide adequate postoperative pain control and the routine use of parenteral opioids aggravates postoperative sedation, nausea, emesis, impaired oxygenation and depressed ventilation.

Hypothesis:

The investigators assume that both ultrasound guided Modified Pecs Block and combination of Ketamine and Magnesium sulphate infusion can achieve better analgesia in major breast cancer surgery in the form of reducing total amount of intraoperative fentanyl requirement and reducing postoperative morphine requirement and improvement of postoperative VAS scores both at rest and during shoulder movement so we plan this study to evaluate this assumption

Detailed Description

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Surgery on the chest wall is relatively common and can be associated with significant postoperative discomfort and pain; and one of the most common surgical sites on the chest wall is the breast, with the main indication for breast surgery being breast cancer. Breast cancer has continued to be the most common cancer in females, accounting for approximately 31% of all newly detected cancer cases in the female population, worldwide. (1, 2) Thousands of patients undergo surgery in the mammary and axillary regions every year, and these procedures tend to cause significant acute pain and may develop in to cases of chronic pain in 25-60% of cases. (3) Pain can be controlled using systemic opioids which have a respiratory depressant effect and causing nausea and vomiting.

Also can be controlled using epidural catheter that can cause haemodynamic instability, so we are searching about how to devrease pain with less complications.

Conditions

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Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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pectoral nerves block group

modified pectoral nerves block was performed on the side of surgery

Group Type ACTIVE_COMPARATOR

pectoral nerves block group

Intervention Type PROCEDURE

ultrasound guided block of nerve supply of surgical site

Ktamine plus Magnesium group

Patients received 40 mg/kg of magnesium sulphate infusion in 100cc normal saline, as a bolus dose, in addition to 0.2mg/kg of ketamine as a bolus dose, 15 min before the induction of general anesthesia. This was followed by intraoperative continuous infusion of 10 mg/kg/h of magnesium sulphate combined with infusion of 0.1mg/kg/h ketamine that was started before skin incision and continued until completion of skin closure via infusion pump

Group Type ACTIVE_COMPARATOR

Ketamine plus magnesium group

Intervention Type DRUG

Patients received 40 mg/kg of magnesium sulphate infusion in 100cc normal saline, as a bolus dose, in addition to 0.2mg/kg of ketamine as a bolus dose, 15 min before the induction of general anesthesia. This was followed by intraoperative continuous infusion of 10 mg/kg/h of magnesium sulphate combined with infusion of 0.1mg/kg/h ketamine that was started before skin incision and continued until completion of skin closure via infusion pump (Atom Syringe Pump S-1235).

Control Group

Normal saline infusion with similar rate and volume to KM infusion was used as a placebo

Group Type ACTIVE_COMPARATOR

Control group

Intervention Type DRUG

Normal saline infusion with similar rate and volume to KM infusion was used as a placebo.

Interventions

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pectoral nerves block group

ultrasound guided block of nerve supply of surgical site

Intervention Type PROCEDURE

Ketamine plus magnesium group

Patients received 40 mg/kg of magnesium sulphate infusion in 100cc normal saline, as a bolus dose, in addition to 0.2mg/kg of ketamine as a bolus dose, 15 min before the induction of general anesthesia. This was followed by intraoperative continuous infusion of 10 mg/kg/h of magnesium sulphate combined with infusion of 0.1mg/kg/h ketamine that was started before skin incision and continued until completion of skin closure via infusion pump (Atom Syringe Pump S-1235).

Intervention Type DRUG

Control group

Normal saline infusion with similar rate and volume to KM infusion was used as a placebo.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* female patients with American society of Anesthesia classification(ASA) II physical status undergoing major breast cancer surgery with axillary evacuation under general anesthesia.
* Patients' age from18 to 65 Years.
* Body mass index (BMI) are from 20 to 40 kg/m2.

Exclusion Criteria

* Pregnant patients
* Patients having sensitivity or contraindication to test drugs or regional anesthesia.
* severe respiratory or cardiac disorders.
* history of psychological disorder.
* chronic pain .
* significant liver or renal insufficiency. .
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute, Egypt

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Salah Ahmed Abd Elgalil

Lecturer of Anesthesia and pain medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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National Cancer Institute

Al Haram, Giza Governorate, Egypt

Site Status RECRUITING

Countries

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Egypt

Facility Contacts

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Ahmed S Ahmed, MD

Role: primary

+20 01098426689

Other Identifiers

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N10-2017

Identifier Type: -

Identifier Source: org_study_id