Background: A large number of patients undergoing major surgical procedures for the
management of breast cancer complain of acute postoperative pain. The present study
aimed to evaluate the effect of dexmedetomidine when added as an adjuvant to bupivacaine
on the quality of this block after modified radical mastectomy (MRM) surgery.
Patients and methods: Patients were randomly divided into two equal groups after induction
of general anaesthesia. Bupivacaine group (I) (n = 30): received bupivacaine 0.25% in a dose of
0.5 ml/kg injected superficial to serratus anterior muscle. Bupivacaine–dexmedetomidine
group (II) (n = 30): received bupivacaine of 0.25% as described above plus dexmedetomidine
(0.5 μg/kg) injected superficial to serratus anterior muscle.
Results: Requesttime for first analgesic (duration of analgesia in group II (19 ± 3 h) when
compared to the group I (14 ± 4 h) and decrease doses of morphine consumption postoperatively
(group II (6 ± 2 mg/24 h) when compared to the group I (10 ± 2 mg/24 h)(p 0.01).
Conclusion: Dexmedetomidine used as an adjuvant to bupivacaine in ultrasound-guided
serratus plane block during modified radical mastectomy surgery leads to an increase of
analgesic effect and decrease doses of morphine consumption postoperatively.