Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Anesthesia and Pain Relief

Thoracotomy is associated with severe pain due to involving incision to multiple muscle layers, rib resection and damage to the intercostal nerves. A post thoracotomy pain free state enables patients to ambulate and to breathe normally and deeply and prevent the conversion into a chronic post thoracotomy pain which is difficult to treat thus, prevention and treatment of acute post-thoracotomy pain is particularly important not only to keep the patient comfortable but also to minimize pulmonary complications. Thoracic epidural analgesia has been established as a cornerstone in the perioperative care after thoracic surgery providing most effective analgesia. However, the use of thoracic epidural analgesia is associated with potential serious and fatal complications.Ultrasound-guided Serratus anterior plane (SAP) block has been described as a regional anesthetic technique to provide analgesia for breast and thoracic wall surgeries.During SAP block Local anesthesia are deposited in the fascial plane either superficial or deep to the serratus anterior muscle. Serratus anterior block provides analgesia to a hemithorax by blocking the lateral branches of the intercostal nerves and is technically simple and can be safely performed as a bedside procedure with low incidence of low risk of side-effects.One hundred and eighty patients who underwent thoracic surgery at the national cancer institute, Cairo University were included in this prospective, randomized, and controlled study

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