None listed
Conditions
Brief summary
In this randomized, controlled trial, the effect of rhomboid intercostal block (RIB) will be evaluated following breast cancer surgery. Our primary hypothesis is that ultrasound-guided RIB combined with general anesthesia will reduce postoperative opioid consumption following breast cancer surgery. Our secondary hypothesis is that RIB will accelerate quality of recovery scores of patients. Another secondary aim is to assess the effect of RIB on postoperative pain scores and rescue analgesic consumptions. All patients will receive a standard anesthesia procedure. In the first group (Group R), patients will receive a rhomboid intercostal block with 30 ml of 0.25% bupivacaine. In the second group, patients will receive intravenous 1 mg kg-1 tramadol and no block intervention will be applied.
Interventions
In the first group (Group R), patients will be placed in lateral decubit position with the involved breast lying superiorly. The ipsilateral arm will be adducted across the chest. A rhomboid intercostal block will be performed by the anesthesiologist. A high-frequency (6–12 MHz) linear ultrasound probe will be placed medial to the medial border of the scapula. The ultrasound landmarks, trapezius muscle, rhomboid muscle, intercostal muscles, pleura and lung will be identified. Under aseptic condi
In the first group (Group R), patients will be placed in lateral decubit position with the involved breast lying superiorly. The ipsilateral arm will be adducted across the chest. A rhomboid intercostal block will be performed by the anesthesiologist. A high-frequency (6–12 MHz) linear ultrasound probe will be placed medial to the medial border of the scapula. The ultrasound landmarks, trapezius muscle, rhomboid muscle, intercostal muscles, pleura and lung will be identified. Under aseptic conditions, an 80- mm 21-gauge needle will be inserted at the level of T5. A single injection of 30 ml of 0.25% bupivacaine will be applied into the interfascial plane between the rhomboid major and intercostal muscles. All patients will receive intravenous ondansetron 4 mg, dexamethasone 8 mg and dexketoprofen trometamol 50 mg for postoperative nausea prophylaxis 15 min before the end of the surgery. At the end of the operation, all patients will receive intravenous tramadol 1 mg kg-1 for postoperative analgesia.
Sponsors
Basak ALTIPARMAK
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Patients between 18-70 years old, with American Society of Anesthesiologists (ASA) physical status I-II, and scheduled for an elective unilateral mastectomy surgery with sentinel node biopsy and Modified Radical Mastectomy surgery with axillary lymph node dissection.
Exclusion criteria
Patients with coagulation disorder, chronic opioid use, psychologic disorder, known allergy to study drugs, history of previous mastectomy or other thoracic surgery, body mass index >? 35 kg m2, inability to use patient-controlled analgesia (PCA) device and surgical time longer than 150 minutes.
Outcome results
None listed