Breast Neoplasm
Conditions
Keywords
breast neoplasms
Brief summary
Pectoral nerve blocks (PECS blok) are used in postoperative analgesia after breast surgery in nowadays. Many studies shows that pectoral nerve blocks is effective for reducing pain and postoperative opioid consumption undergoing mastectomy. This study was planned to evaluate the efficacy of intraoperative PECS block for postoperative analgesia after robot breast surgery and immediate breast reconstruction.
Detailed description
Sixty patients were randomly allocated into two groups by computerised process, each including 30 patients. PECS group (P) received general anesthesia and pectoral nerve block(PECS block) with 025% ropivacaine after surgical resection of breast by operator. Control group(C) only received general anesthesia. A Patient -controlled analgesia(PCA) device provides fentanyl for postoperative pain control. The Primary outcome measures total dose of fentanyl consumption during the postoperative 24 hours, and secondary outcome measures pain scores at rest and movement.
Interventions
PROCEDUREpectoral nerve block
Patients received standardized general anesthesia. PECS block were applied under vision using blunted tip cannula(27G, 30mm) after surgical resection of breast by operator. 0.25% ropivacaine 10ml was injected into fascia between pectoralis major and minor muscles. 0.25% ropivacaine 20ml was injected into fascia between pectoralis minor and serratus anterior muscles at the level of the third rib. Breast reconstruction is performed after PECS block
Sponsors
Yonsei University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. 20years or older 2. Scheduled for robot-assisted nipple-sparing mastectomy with immediate gel implant or tissue expander breast reconstruction 3. American Society of Anesthesiologists(ASA) physical status I and III
Exclusion criteria
1. Emergency operation 2. Reoperation 3. Patients with local anesthetic allergy 4. Patients with coagulopathy 5. Patients on anticoagulants 6. Patients who cannot use patient controlled analgesia(PCA) 7. Patients with morbid obesity \[body mass index (BMI) \>35 kg/m2\] 8. Patients with history of uncontrolled hypertension (diastolic BP \>110mmHg) or DM 9. Patients with history of heart failure (unstable angina, congestive heart failure) 10. Patients with history of liver failure, renal failure, allergic to medicine 11. Patients with history of cerebrovascular disease (cerebral hemorrhage, cerebral ischemia) 12. Patients with history of uncontrolled psychiatric disease (PTSD, anxiety, depression) 13. Patients who cannot read the consent form (examples: Illiterate, foreigner) 14. Patients who withdraw the consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total dose of fentanyl consumption during the postoperative 24h | after 24 hours postoperative period | To evaluate the effect of PECS block undergoing robot-assisted nipple-sparing mastectomy (RANSM) with immediate breast reconstruction (IBR), total cumulative dose of fentanyl was measured for the first postoperative 24h |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| a numeric rating score at rest | 0 hour after surgery | Secondary outcome measures were postoperative pain using numeric rating score (NRS, 0-10; 0=no pain and 10=worst imaginable pain) |
| a numeric rating score at movement | 0 hour after surgery | Secondary outcome measures were postoperative pain using numeric rating score (NRS, 0-10; 0=no pain and 10=worst imaginable pain) |
Countries
South Korea
Outcome results
None listed