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

1 Karmakar MK, Samy W, Li JW, Lee A, Chan WC, Chen PP, et al. Thoracic paravertebral block and its effects on chronic pain and health-related quality of life after modified radical mastectomy. Reg Anesth Pain Med. 2014;39(4):289-98. https://doi.org/10.1097/AAP.0000000000000113 PMid:24956453 Search in Google Scholar

2 Kim SY, Song JW, Park B, Park S, An YJ, Shim YH. Pregabalin reduces post-operative pain after mastectomy: A double-blind, randomized, placebo-controlled study. Acta Anaesthesiol Scand. 2011;55(3):290-6. https://doi.org/10.1111/j.1399-6576.2010.02374.x PMid:21288209 Search in Google Scholar

3 Plunkett A, Scott TL, Tracy E. Regional anesthesia for breast cancer surgery: Which block is best? A review of the current literature. Pain Manag. 2022;12(8):943-50. https://doi.org/10.2217/pmt-2022-0048 PMid:36177958 Search in Google Scholar

4 Mayes J, Davison E, Panahi P, Patten D, Eljelani F, Womack J, et al. An anatomical evaluation of the serratus anterior plane block. Anaesthesia. 2016;71(9):1064-9. https://doi.org/10.1111/anae.13549 PMid:27440171 Search in Google Scholar

5 Prabhakar A, Lambert T, Kaye RJ, Gaignard SM, Ragusa J, Wheat S, et al. Adjuvants in clinical regional anesthesia practice: A comprehensive review. Best Pract Res Clin Anaesthesiol. 2019;33(4):415-23. https://doi.org/10.1016/j.bpa.2019.06.001 PMid:31791560 Search in Google Scholar

6 Huynh TM, Marret E, Bonnet F. Combination of dexamethasone and local anaesthetic solution in peripheral nerve blocks: A meta-analysis of randomised controlled trials. Eur J Anaesthesiol. 2015;32(11):751-8. https://doi.org/10.1097/EJA.0000000000000248 PMid:25774458 Search in Google Scholar

7 Nath TS. Case report: Effectiveness of low-dose ketamine infusion in opioid refractory cancer pain. Cureus. 2022;14(11):e31662. https://doi.org/10.7759/cureus.31662 PMid:36545179 Search in Google Scholar

8 Othman AH, El-Rahman AM, El Sherif F. Efficacy and safety of ketamine added to local anesthetic in modified pectoral block for management of postoperative pain in patients undergoing modified radical mastectomy. Pain Physician. 2016;19(7):485-94. Search in Google Scholar

9 Hefni AF, Eldeek AM, Ismael SA, Shaban AR. Comparing effect of adding ketamine versus dexmedetomidine to bupivacaine in Pecs-ec Block on postoperative pain control in patients undergoing breast surgery. Clin J Pain. 2022;38(9):568-74. https://doi.org/10.1097/AJP.0000000000001055 PMid:35777735 Search in Google Scholar

10 Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49. https://doi.org/10.3322/caac.21660 PMid:33538338 Search in Google Scholar

11 Fecho K, Miller NR, Merritt SA, Klauber-Demore N, Hultman CS, Blau WS. Acute and persistent postoperative pain after breast surgery. Pain Med. 2009;10(4):708-15. https://doi.org/10.1111/j.1526-4637.2009.00611.x PMid:19453965 Search in Google Scholar

12 Albi-Feldzer A, Dureau S, Ghimouz A, Raft J, Soubirou JL, Gayraud G, et al. Preoperative paravertebral block and chronic pain after breast cancer surgery: A double-blind randomized trial. Anesthesiology. 2021;135(6):1091-103. https://doi.org/10.1097/ALN.0000000000003989 PMid:34618889 Search in Google Scholar

13 Hussain N, Brull R, McCartney CJL, Wong P, Kumar N, Essandoh M, et al. Pectoralis-II myofascial block and analgesia in breast cancer surgery: A systematic review and meta-analysis. Anesthesiology. 2019;131(3):630-48. https://doi.org/10.1097/ALN.0000000000002822 PMid:31408448 Search in Google Scholar

14 Li ZH, Hong WJ, Guo XL, Li XR, Jiang XY, Jiang Y, et al. Serratus plane block in breast cancer surgery: A systematic review and meta-analysis. Clin Breast Cancer. 2023;23(1):e1-13. https://doi.org/10.1016/j.clbc.2022.10.009 PMid:36357268 Search in Google Scholar

15 Blanco R, Parras T, McDonnell JG, Prats-Galino A. Serratus plane block: A novel ultrasound-guided thoracic wall nerve block. Anaesthesia. 2013;68(11):1107-13. https://doi.org/10.1111/anae.12344 PMid:23923989 Search in Google Scholar

16 Tan KW, Sayed Masri SN, Musthafa QA, Mohd Azidin A, Nik Mohamed Kamil A, Izaham A, et al. Analgesic efficacy of the superficial versus deep serratus plane blocks for mastectomy with axillary clearance: A randomized controlled trial. Medicine (Baltimore). 2022;101(35):e30515. https://doi.org/10.1097/MD.0000000000030515 PMid:36107598 Search in Google Scholar

17 El-Boghdadly K, Pawa A, Chin KJ. Local anesthetic systemic toxicity: Current perspectives. Local Reg Anesth. 2018;11:35-44. https://doi.org/10.2147/LRA.S154512 PMid:30122981 Search in Google Scholar

18 Margulis R, Francis J, Tischenkel B, Bromberg A, Pedulla D, Grtisenko K, et al. Comparison of dexmedetomidine and dexamethasone as adjuvants to ultra-sound guided interscalene block in arthroscopic shoulder surgery: A double-blinded randomized placebo-controlled study. Anesth Pain Med. 2021;11(3):e117020. https://doi.org/10.5812/aapm.117020 PMid:34540645 Search in Google Scholar

19 Gouda N, Zangrilli J, Voskerijian A, Wang ML, Beredjiklian PK, Rivlin M. Safety and duration of low-dose adjuvant dexamethasone in regional anesthesia for upper extremity surgery: A prospective, randomized, controlled blinded study. Hand (N Y). 2022;17(6):1236-41. https://doi.org/10.1177/15589447211008558 PMid:33880959 Search in Google Scholar

20 Zhang D, Zhou C, Wei D, Ge L, Li Q. Dexamethasone added to local anesthetics in ultrasound-guided transversus abdominis plain (TAP) block for analgesia after abdominal surgery: A systematic review and meta-analysis of randomized controlled trials. PLoS One. 2019;14(1):e0209646. https://doi.org/10.1371/journal.pone.0209646 PMid:30620730 Search in Google Scholar

21 Pehora C, Pearson AM, Kaushal A, Crawford MW, Johnston B. Dexamethasone as an adjuvant to peripheral nerve block. Cochrane Database Syst Rev. 2017;11(11):CD011770. https://doi.org/10.1002/14651858.CD011770.pub2 PMid:29121400 Search in Google Scholar

22 Chen JQ, Chen JR, Wang S, Gao W, Gu H, Yang XL, et al. Effect of perineural dexamethasone with ropivacaine in continuous serratus anterior plane block for postoperative analgesia in patients undergoing video-assisted thoracoscopic surgery. J Pain Res. 2022;15:2315-25. https://doi.org/10.2147/JPR.S372071 PMid:35992248 Search in Google Scholar

23 Woo JH, Kim YJ, Kim DY, Cho S. Dose-dependency of dexamethasone on the analgesic effect of interscalene block for arthroscopic shoulder surgery using ropivacaine 0.5%: A randomised controlled trial. Eur J Anaesthesiol. 2015;32(9):650-5. https://doi.org/10.1097/EJA.0000000000000213 PMid:25603389 Search in Google Scholar

24 Kirkham KR, Jacot-Guillarmod A, Albrecht E. Optimal dose of perineural dexamethasone to prolong analgesia after brachial plexus blockade: A systematic review and meta-analysis. Anesth Analg. 2018;126(1):270-9. https://doi.org/10.1213/ANE.0000000000002488 PMid:28922230 Search in Google Scholar

25 Abdallah FW, Johnson J, Chan V, Murgatroyd H, Ghafari M, Ami N, et al. Intravenous dexamethasone and perineural dexamethasone similarly prolong the duration of analgesia after supraclavicular brachial plexus block: A randomized, triple-arm, double-blind, placebo-controlled trial. Reg Anesth Pain Med. 2015;40(2):125-32. https://doi.org/10.1097/AAP.0000000000000210 PMid:25629321 Search in Google Scholar

26 Rwei AY, Sherburne RT, Zurakowski D, Wang B, Kohane DS. Prolonged duration local anesthesia using liposomal bupivacaine combined with liposomal dexamethasone and dexmedetomidine. Anesth Analg. 2018;126(4):1170-5. https://doi.org/10.1213/ANE.0000000000002719 PMid:29239940 Search in Google Scholar

27 Chong MA, Szoke DJ, Berbenetz NM, Lin C. Dexamethasone as an adjuvant for caudal blockade in pediatric surgical patients: A systematic review and meta-analysis. Anesth Analg. 2018;127(2):520-8. https://doi.org/10.1213/ANE.0000000000003346 PMid:29596095 Search in Google Scholar

28 Zhu C, Zhang S, Gu Z, Tong Y, Wei R. Caudal and intravenous dexamethasone as an adjuvant to pediatric caudal block: A systematic review and meta-analysis. Paediatr Anaesth. 2018;28(3):195-203. https://doi.org/10.1111/pan.13338 PMid:29436137 Search in Google Scholar

29 Bravo D, Aliste J, Layera S, Fernández D, Leurcharusmee P, Samerchua A, et al. A multicenter, randomized comparison between 2, 5, and 8 mg of perineural dexamethasone for ultrasound-guided infraclavicular block. Reg Anesth Pain Med. 2019;44(1):46-51. https://doi.org/10.1136/rapm-2018-000032 PMid:30640652 Search in Google Scholar

30 Erdman HB, Kornilov E, Kahana E, Zarchi O, Reiner J, Socher A, et al. Asleep DBS under ketamine sedation: Proof of concept. Neurobiol Dis. 2022;170:105747. https://doi.org/10.1016/j.nbd.2022.105747 PMid:35550159 Search in Google Scholar

31 Célèrier E, Rivat C, Jun Y, Laulin JP, Larcher A, Reynier P, et al. Long-lasting hyperalgesia induced by fentanyl in rats: preventive effect of ketamine. Anesthesiology. 2000;92(2):465-72. https://doi.org/10.1097/00000542-200002000-00029 PMid:10691234 Search in Google Scholar

32 Reddi D, Curran N. Chronic pain after surgery: Pathophysiology, risk factors and prevention. Postgrad Med J. 2014;90(1062):222-7. https://doi.org/10.1136/postgradmedj-2013-132215 PMid:24572639 Search in Google Scholar

33 Sunder RA, Toshniwal G, Dureja GP. Ketamine as an adjuvant in sympathetic blocks for management of central sensitization following peripheral nerve injury. J Brachial Plex Peripher Nerve Inj. 2008;3:22. https://doi.org/10.1186/1749-7221-3-22 PMid:18950516 Search in Google Scholar

34 Abdel-Ghaffar ME, Abdulatif MA, Al-Ghamdi A, Mowafi H, Anwar A. Epidural ketamine reduces post-operative epidural PCA consumption of fentanyl/bupivacaine. Can J Anaesth. 1998;45(2):103-9. https://doi.org/10.1007/BF03013246 PMid:9512842 Search in Google Scholar

35 Imani F, Bagheri A, Arvin E, Gatt SP, Sarveazad A. Effects of ketamine and lidocaine infusion on acute pain after elective open abdominal surgery, a randomized, double-blinded study. Med J Islam Republ Iran. 2022;36:60. https://doi.org/10.47176/mjiri.36.60 PMid:36128312 Search in Google Scholar

36 Zhu T, Gao Y, Xu X, Fu S, Lin W, Sun J. Effect of ketamine added to ropivacaine in nerve block for postoperative pain management in patients undergoing anterior cruciate ligament reconstruction: A randomized trial. Clin Ther. 2020;42(5):882-91. https://doi.org/10.1016/j.clinthera.2020.03.004 PMid:32247522 Search in Google Scholar

37 Mohmed A, Hassanein A, Mansour H. Ketamine Versus Dexmedetomidine as an Adjuvant in Ultrasound-guided Supraclavicular Brachial Plexus Block: A Double-blind Randomized Clinical Trial. In Review; 2021. Available from: https://www.researchsquare.com/article/rs-128342/v1 [Last accessed on 2023 Oct 15]. Search in Google Scholar

38 Stephan J, Saba H, El Metni A, Kamel K. B353 Comparision of Dexmedetomidine, Dexamethasone, Ketamine as Adjuvants to Ropivacaine in Transverse Abdominis plane Block for Cesarean Section: A Prospective Randomized Study. Postoperative Pain Management. BMJ Publishing Group Ltd.; 2022. p. A253. Available from: https://rapm.bmj.com/lookup/doi/10.1136/rapm-2022-ESRA.428 [Last accessed on 2023 Nov 06]. Search in Google Scholar

39 Abdelhamid BM, Samy S, Abdalla A, Saad A, Ollaek M, Ahmed A. Ketamine versus neostigmine as adjuvants to bupivacaine during ultrasound-guided serratus anterior plane block in modified radical mastectomy. A randomized controlled trial. Egypt J Anaesth. 2021;37:356-63. Search in Google Scholar

40 El Mourad MB, Amer AF. Effects of adding dexamethasone or ketamine to bupivacaine for ultrasound-guided thoracic paravertebral block in patients undergoing modified radical mastectomy: A prospective randomized controlled study. Indian J Anaesth. 2018;62(4):285-91. https://doi.org/10.4103/ija.IJA_791_17 PMid:29720754 Search in Google Scholar

41 Tan ZL, Zhou ZY, Zhou X, Zhang L, Cao HJ. The protective effect of high heme oxygenase-1 expression induced by propofol on the alveolar II type epithelial cells of rats with acute lung injury induced by oleic acid. J Physiol Pharmacol. 2021;72(3):451-9. https://doi.org/10.26402/jpp.2021.3.13 PMid:34873068 Search in Google Scholar

42 Mohammadzadeh Jouryabi A, Sharami SH, Mansour Ghanaie M, Sedighinejad A, Imantalab V, Rafiee Sorouri Z, et al. Comparing the effects of low dose of ketamine, tramadol, and ondansetron in prevention of post spinal anesthesia shivering in cesarean section. Anesth Pain Med. 2021;11(4):e116429. https://doi.org/10.5812/aapm.116429 PMid:34692439 Search in Google Scholar