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ultrasound-guided pectoral nerve block (pec ii) versus serratus anterior plane block (sapb) for pain control following modified radical mastectomy
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نویسنده
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ibrahim doaa mohamed almonayery ,abd elhadi ali wafaa ali ,morsy hayam shaaban soliman ,eid marwa ibrahim ,abdelaziz fatma mohamed ,salem eman a. ,eldesoky gehan abd elrhman ,gad asmaa ibraheim ,shams doaa elsaid ahmed ,ibrahim hamouda samia ibrahim ,atwa heba atwa ahmed ,negm marwa fouad ,ashour hala abdelfatah ibrahim ,abd alrahman mona salah eldin sayed ,mohamad taiseer abdulnaser abofadl ,elsakhawy hend abdelmonem ,elshamy mahmoud mostafa ,elsayed abdelkarem hussiny ismail ,arafa mohamed hassan mohamed hassan ,elghonimy mohamad mohamad abdelhamed ,selim mahmoud mohamed mohamed abdallah ,aly taha ahmed abdeldayem ,zabady muhammad mosleh muhammad muhammad ,sheashia hazem ali essa ali ,omar abdulmabod ,ragab ayman saleh mohamed ,mahmoud ibrahim fadl ,elbohouty mayada yahia ,ali esmail ali mohamed
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منبع
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journal of medicinal and pharmaceutical chemistry research - 2026 - دوره : 8 - شماره : 4 - صفحه:938 -952
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چکیده
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Modified radical mastectomy (mrm) is frequently associated with significant postoperative pain due to extensive dissection involving the breast and axillary region. while regional anesthesia techniques such as pectoral nerve block (pec ii) and serratus anterior plane block (sapb) have emerged as effective modalities for perioperative pain control, the comparative efficacy of these blocks remains inadequately explored. the objective of this study is to compare the analgesic efficacy, opioid-sparing effect, and incidence of postoperative complications between ultrasound- guided pec ii and sapb in female patients undergoing mrm. this prospective, randomized controlled trial included 70 female patients (asa i–ii), aged 35–60 years, scheduled for mrm under general anesthesia. the patients were randomly allocated into two groups: group i received pec ii block (n=35), and group ii received sapb (n=35). the primary outcome was the time to first analgesic request. secondary outcomes included postoperative pain scores (nrs), total opioid consumption over 24 hours, hemodynamic parameters, and incidence of postoperative nausea and vomiting (ponv). sapb resulted in significantly longer time to first analgesic requirement (6.97 ± 2.24 h vs. 4.47 ± 1.43 h in pecii, p<0.001) and reduced total pethidine consumption (25.00 ± 0.00 mg vs. 43.91 ± 7.46 mg, p<0.001). sapb provides superior postoperative analgesia compared to pec ii in patients undergoing mrm. it significantly prolongs the duration of analgesia, reduces opioid consumption and side effects, and enhances hemodynamic stability. sapb may be considered the preferred regional technique in breast surgery involving axillary dissection.
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کلیدواژه
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modified radical mastectomy ,postoperative pain ,regional anesthesia ,pectoral nerve block ,serratus anterior plane block ,opioid sparing ,ultrasound-guided block
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آدرس
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al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of general surgery, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine, department of anesthesia and intensive care & pain management, egypt, al-azhar university, faculty of medicine, department of anesthesia and intensive care & pain management, egypt, al-azhar university, faculty of medicine, department of anesthesia and intensive care & pain management, egypt, al-azhar university, faculty of medicine, department of anesthesia and intensive care & pain management, egypt, al-azhar university, faculty of medicine, department of anesthesia and intensive care & pain management, egypt, al-azhar university, faculty of medicine, department of anesthesia and intensive care & pain management, egypt, al-azhar university, faculty of medicine, department of anesthesia and intensive care & pain management, egypt, general organization of teaching hospitals and institutes, benha teaching hospital, department of anesthesia and intensive care, egypt, al-azhar university, faculty of medicine, egypt, al-azhar university, damietta faculty of medicine, department of anesthesiology, intensive care and pain medicine, egypt, al-azhar university, damietta faculty of medicine, department of anesthesiology, intensive care and pain medicine, egypt, al-azhar university, faculty of medicine for girls, department of anesthesia, intensive care & pain management, egypt, al-azhar university, faculty of medicine, department of anesthesia and intensive care & pain management, egypt
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پست الکترونیکی
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aliesmai@yahoo.com
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Authors
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