Background and Aims: Erector spinae plane block, Paravertebral block and serratus anterior block are three formats for analgesia post-operatively following radical mastectomy. This study compares the analgesic efficacy of these modalities for analgesia post-operatively by articaine 2% with adrenaline. Methods: Seventy-five patients with ASA physical status I or II subjected to modified radical mastectomy with axillary clearance were enrolled for the study. After induction of general anaesthesia all patients received 20 mL 2% articaine with adrenaline in each technique of the study. Patients in Group 1 (Erector spinae block [ESB], n = 25), Group 2 paravertebral block [PVB] n = 25), Group 3 (serratus anterior plane block [SAPB] n = 25) were ultrasound-guided on ipsilateral side. Patients were estimated for pain scores at 0, 2, 4, 6, 12 and 24 h, and duration of analgesia post-operatively and relieve analgesic doses required of morphine up to 24 h. Results: Visual analogue scale scores post-operatively were lower in ESB and PVB group compared with SAPB at 4, 6, 12 and 24 h (P < 0.05). The first analgesic dose requirement was significantly longer in ESB (416 ± 68 min) than PVB group (371 ± 67 min) in compared with SAPB (343.5 ± 54.7 min). Mean duration of analgesia was significantly longer in ESB and PVB group (P < 0.001) in compared with SAPB. Total morphine dose of relieving analgesic was significantly lesser in ESB (4 ± 2 mg) than PVB group (6 ± 2 mg) compared with SAPB

Aim: To evaluate the analgesic effect of superior hypogastric plexus (SHP) area infiltration with 20 ml bupivacaine0.5% on post total abdominal hysterectomy (TAH) pain. Patients and Methods: This a prospective randomized, double blind, placebo controlled study, conducted at Benha University Hospital, including sixty women undergoin TAH, thirty women received 20 ml bupivacaine 0.5% and thirty women received 20 ml saline infiltrated in SHP area at end of TAH. Main outcomes measures were total cumulative Nalbuphine consumption and post TAH pain using visual analogue scale (VAS), as well as nausea, vomiting, other analgesic requirements, time spent in post anaesthesia care unit (PACU), time to get out of bed.

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Background: Ultrasound-guided for regional anesthesia offers many potential benefits in the emergency setting. Analgesia can be explicitly targeted to the region of pain and provide relief for many hours and decrease needing to the large volume of local anesthetic. The aim of the work: Comparing the efficacy of dexmedetomidine when used as an adjuvant to bupivacaine in supraclavicular brachial plexus blocks on the onset of sensory, motor blockade and postoperative analgesia. Patients and methods: This prospective, randomized, single-blind clinical study conducted on 60 patients underwent upper limb surgery done by ultrasound-guided supraclavicular brachial plexus block; these patients allocated into two equal groups: Group I (control) received 20 ccs (19 cc bupivacaine 0.5% + 1 cc saline), Group II received 20 cc (19 cc bupivacaine 0.5% + 1 cc volume of Dexmedetomidine 1 ug/kg). Results: Demographic data and surgical characteristics were comparable in both groups. The onset times for sensory and motor blocks were significantly shorter in Group II than Group I (P < 0.001), while the duration of blocks was considerably longer (P < 0.001) in Group II. Except for the first recordings (at 0, 5, and 10 min), heart rate levels in Group II were significantly lower (P < 0.001). MBP levels in Group II at 15, 30, 45, 60, 90 and 120 min were significantly lower than in Group I (P < 0.001). The duration of analgesia (DOA) was significantly longer in Group II than Group I (P < 0.001). As regards to the visual Analouge score, there is a highly significant difference at 6 hours, 8 hours and 10 hours in Group II than Group I. Conclusion: We recommend adding Dexmedetomidine to local anesthetics in peripheral nerve blocks to take advantage of the prolonged time of both sensory and motor blocks and prolonged postoperative analgesia.

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