Recruiting
Compare Analgesia Between MTP Block And ESPB in MRM
This study is conducted to compare the analgesic efficacy between ultrasound guided Erector Spinae Plane block Vs midpoint transverse process to Pleura block in modified radical mastectomy surgeries
ClinicalTrials.gov IDNCT06888258
PhaseNA
Enrollment90
SponsorNational Cancer Institute, Egypt
Age18 Years – 60 Years
SexALL
Conditions studied
Breast Cancer
About this study
This study is conducted to compare the analgesic efficacy between ultrasound guided Erector Spinae Plane block Vs midpoint transverse process to Pleura block in modified radical mastectomy surgeries
Interventions
- Procedure: Ultrasound guided Erector Spinae Plane block — Group E: The block will be performed preoperatively with full aseptic precautions. The ultrasound probe will be placed on the back in a vertical orientation on the lateral side of the posterior median line to identify the transverse process of the 5th thoracic vertebra and erector spine muscle. A skin wheal using 3ml of 1% lidocaine will be made 2 to 3 cm superior to the superior aspect of the transducer. The puncture will be performed using the intra-plane needling technique after local anaesthesia infiltration. A 20-gauge Tuohy needle connected to a syringe containing the anesthetic mixture or saline will be advanced. When the puncture needle touch the transverse process, with no blood, gas, or cerebrospinal fluid observed on aspiration, 20 mL of 0.25% bupivacaine will be administered between the erector spine muscle and transverse process. Local anesthetic diffusion between the transverse process and erector spinae muscle is an indication of a successful puncture.
- Procedure: Ultrasound guided Mid-point to Pleura block — Group M: The block will be performed preoperatively with full aseptic precautions. The ultrasound probe will be placed on the back in a vertical orientation on the lateral side of the posterior median line to identify the transverse processes of the 4th and 5th thoracic vertebrae and pleura. A skin wheal using 3ml of 1% lidocaine will be made 2 to 3 cm superior to the superior aspect of the transducer. Using the in plane needling technique in the space between the transverse processes of the 4th and 5th thoracic vertebrae, the puncture needle needle tip will be placed at the mid-point between the transverse process and pleura, with no blood, gas, or cerebrospinal fluid observed on aspiration, 20 mL of 0.25% bupivacaine will be administered. The local anesthetic spread will be noted in the area midway between the transverse process and pleura is an indication of a successful puncture.
Primary outcomes
- post-operative opioid (morphine) consumption in the 1st 24 hours (24 hours)
Eligibility information
Inclusion Criteria:
* ASA I-II.
* Undergoing modified radical mastectomy surgery.
* Body mass index (BMI) from 18.5 to 30 kg/m2
Exclusion Criteria:
* Patient refusal.
* Known allergy to local anesthetics.
* Bleeding disorders; platelets count \<50,000 , prothrombin concentration \< 60% or any coagulopathy disorder.
* Use of any anti-coagulants.
* Inability to provide informed consent.
* ASA III-IV.
* Neurological disorders.
* Patient with psychiatric disorders
Study locations
- National cancer institute, Cairo University, Cairo, 11796 Egypt
Before you participate: Varda Clinical is an independent discovery tool, not the study sponsor or a medical provider. Eligibility can only be determined by the official study team. Discuss potential risks and benefits with a qualified healthcare professional.
Source: ClinicalTrials.gov. Record last refreshed by Varda Clinical: 2026-11-01.