Pain After Mastectomy
Conditions
Keywords
ropivacaine, pain, mastectomy
Brief summary
After surgery for breast cancer, the prevalence of chronic pain is estimated between 20 and 68%. They begin after surgery and may persist until more than 6 months. They respond poorly to opioid analgesics impair the quality of life. Among the different postoperative analgesic techniques used, the use of a local anesthetic infiltration continues catheter has advantages including improving the quality of analgesia, with a significant decrease in average of VAS (scale visual Analogue), a decrease in morphine consumption, improving the quality of life of patients. Our study aims to evaluate the effectiveness of a continuous local anesthetic infiltration in the control of postoperative pain after mastectomy.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
Age\> 18 years * ASA I-II, WHO 0-1 * mastectomy alone, mastectomy + GGS + mastectomy CA * No previous history of chronic pain requiring regular intake of analgesics or long-term * Failure to take opioids within 30 days before surgery
Exclusion criteria
* Long-term treatment analgesic or taking opioids within 30 days before surgery * Concurrent treatment with a drug test, participation in another therapeutic clinical trial within \<30 days * proven allergy to local anesthetics of the amide * Skin Inflammation * Sepsis local * Kidney failure, liver failure, severe or poorly controlled diabetes * Inability to respond to the assessment of pain using a visual analogue scale (VAS) or a numerical scale (FR). * mastectomy with immediate breast reconstruction
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Daily consumption of morphine during the first 48 postoperative hours. | during the first 48 postoperative hours |
Secondary
| Measure | Time frame |
|---|---|
| Assessment every 4 hours by the IDE that will support the patient during the first 48 hours, then every analgesic taken: • The intensity of pain, VAS or EN | During the first 48 h after surgery |
| Assessment every 4 hours by the IDE that will support the patient during the first 48 hours, then every analgesic taken: • The site of pain | during the first 48h after the surgery |
| Assessment every 4 hours by the IDE that will support the patient during the first 48 hours, then every analgesic taken: A potential analgesics administered | during the first 48h after the surgery |
| Assessment every 4 hours by the IDE that will support the patient during the first 48 hours, then every analgesic taken: Constant: pulse, blood pressure, tympanic temperature, respiratory rate, sedation (0: awake, 1: sleepy, 2 comatose). | during 48h after the surgery |
| Determination of Ropivacaine plasma (analytical blank: T0) | T0, the day of surgery |
| Assessment every 4 hours by the IDE that will support the patient during the first 48 hours, then every analgesic taken: Possible side effects of ropivacaine expected the most common: nausea, vomiting, headache, dizziness, paresthesias. | during 48 hours after the surgery |
| Assessment every 4 hours by the IDE that will support the patient during the first 48 hours, then every analgesic taken: Condition of dressing • On any abnormality at the site of administration: local redness, pain, skin warmth, pruritus. | during the 48h after the surgery |
| Assessment every 4 hours by the IDE that will support the patient during the first 48 hours, then every analgesic taken: Determination of Ropivacaine plasma at T0+ 24 h, T0+48h | during 48h after the surgery |
| Assessment every 4 hours by the IDE that will support the patient during the first 48 hours, then every analgesic taken: Possible side effects The most common expected morphine: nausea, vomiting, pruritus, acute urine retention. | during the 48h after the surgery |
Countries
France