<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>BACKGROUND</h3>
<p>Post-operative pain after mastectomy is associated with poor recovery, prolonged hospital stays, and increased liability for chronic persistent pain.</p>
</sec>
<sec><h3>AIM</h3>
<p>This work aimed to test the analgesic efficacy of adding ketamine to a dexamethasone bupivacaine combination in ultrasound-guided serratus anterior plane block (SAPB) in patients undergoing modified radical mastectomy (MRM).</p>
</sec>
<sec><h3>METHODS</h3>
<p>This randomized, double-blind trial included 60 females aged 20–60 undergoing MRM. They were randomized into two groups: Group DB (n = 30) received SAPB using 30 ml of bupivacaine 0.25% and dexamethasone 4 mg. Group KD (n = 30) received the same block with the addition of ketamine 50 mg.</p>
</sec>
<sec><h3>RESULTS</h3>
<p>The time to the first analgesic request was significantly delayed in Group KD than in Group DB (p &lt; 0.001). The number of patients requiring morphine and its total consumption during the first 24 post-operative hours in Group KD were significantly less than in Group DB (p = 0.001 and p &lt; 0.001, respectively). Visual Analog Scale scores at rest and movement at 4, 6, 8, 10, 12, and 18 h were significantly lower in Group KD than in Group DB.</p>
</sec>
<sec><h3>CONCLUSIONS</h3>
<p>Adding ketamine to bupivacaine plus dexamethasone in ultrasound-guided SAPB is associated with better analgesic outcomes in patients undergoing MRM, including prolonged duration of analgesia and decreased post-operative morphine consumption and pain scores at rest and movement.</p>
</sec>
</abstract>

BACKGROUND
Post-operative pain after mastectomy is associated with poor recovery, prolonged hospital stays, and increased liability for chronic persistent pain.

AIM
This work aimed to test the analgesic efficacy of adding ketamine to a dexamethasone bupivacaine combination in ultrasound-guided serratus anterior plane block (SAPB) in patients undergoing modified radical mastectomy (MRM).

METHODS
This randomized, double-blind trial included 60 females aged 20–60 undergoing MRM. They were randomized into two groups: Group DB (n = 30) received SAPB using 30 ml of bupivacaine 0.25% and dexamethasone 4 mg. Group KD (n = 30) received the same block with the addition of ketamine 50 mg.

RESULTS
The time to the first analgesic request was significantly delayed in Group KD than in Group DB (p < 0.001). The number of patients requiring morphine and its total consumption during the first 24 post-operative hours in Group KD were significantly less than in Group DB (p = 0.001 and p < 0.001, respectively). Visual Analog Scale scores at rest and movement at 4, 6, 8, 10, 12, and 18 h were significantly lower in Group KD than in Group DB.

CONCLUSIONS
Adding ketamine to bupivacaine plus dexamethasone in ultrasound-guided SAPB is associated with better analgesic outcomes in patients undergoing MRM, including prolonged duration of analgesia and decreased post-operative morphine consumption and pain scores at rest and movement.

Effects of Adding Dexamethasone Plus Ketamine to Bupivacaine for Ultrasound-guided Serratus Plane Block as Analgesia in Major Breast Surgery: A Randomized, Double-blind Trial

Department of Anesthesia and Pain Management

National Cancer Institute, Cairo University

Open Access Macedonian Journal of Medical Sciences

This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License.

BACKGROUND
Post-operative pain after mastectomy is associated with poor recovery, prolonged hospital stays, and increased liability for chronic persistent...

Effects of Adding Dexamethasone Plus Ketamine to Bupivacaine for Ultrasound-guided Serratus Plane Block as Analgesia in Major Breast Surgery: A Randomized, Double-blind Trial

Published Online: Apr 09, 2024

Page range: 175 - 182

Received: Nov 08, 2023

Accepted: Feb 27, 2024

DOI: https://doi.org/10.3889/oamjms.2024.11825

Keywords
Bupivacaine, Dexamethasone, Ketamine, Modified radical mastectomy, Serratus plane block

© 2024 Ahmed Hussein Bakeer et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License.

Effects of Adding Dexamethasone Plus Ketamine to Bupivacaine for Ultrasound-guided Serratus Plane Block as Analgesia in Major Breast Surgery: A Randomized, Double-blind Trial

Published Online: Apr 09, 2024

Page range: 175 - 182

Received: Nov 08, 2023

Accepted: Feb 27, 2024

DOI: https://doi.org/10.3889/oamjms.2024.11825

KeywordsBupivacaine, Dexamethasone, Ketamine, Modified radical mastectomy, Serratus plane block

© 2024 Ahmed Hussein Bakeer et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License.

Keywords
Bupivacaine, Dexamethasone, Ketamine, Modified radical mastectomy, Serratus plane block