This study aims to compare time of first request of analgesia among patients undergoing rhomboid intercostal sub-serratus plane block versus external oblique intercostal block for perioperative pain management in open nephrectomy.
Both sexes.
American Society of Anesthesiologists (ASA) physical status II, III.
Body mass index (BMI): > 20 kg/ m2 and < 35 kg/ m2.
Patients undergoing open nephrectomy.
Patient refusal.
BMI <20 kg/m2 and >35 kg/m2
Known sensitivity or contraindication to drug used in the study (local anesthetics, opioids).
History of psychiatric and cognitive disorders or chronic pain.
Parallel
Rhomboid intercostal subserratus plane block
Other interventionPatients will receive the rhomboid intercostal subserratus plane block.
External oblique intercostal block
Other interventionPatients will receive the external oblique intercostal block.
Intravenous morphine
DrugPatients will not receive any interventions (Intravenous morphine 0.1mg/kg after induction of general anesthesia).
Time of first request of analgesia
Time of first request of analgesia will be recorded from the end of surgery till first dose of morphine administrated.
Heart rate
Heart rate will be noted immediately on arrival and at 0, 4, 8, 12, 18 and 24 h postoperatively.
Mean arterial blood pressure
Mean arterial blood pressure will be noted immediately on arrival and at 0, 4, 8, 12, 18 and 24 h postoperatively.
Total amount of fentanyl
Fentanyl 0.5 μg / kg will be given in case of heart rate or mean arterial blood pressure ≥ 20% of the baseline
Total morphine consumption
Intravenous morphine (3 mg) will be provided as rescue of analgesia. The total amount of morphine given in 24 h will be recorded.
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