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The Pectoral Block for Breast Augmentation Surgery

Phase 4
Completed
Conditions
Pain, Postoperative
Anesthesia; Regional
Interventions
Procedure: PEC 1 block
Drug: Normal saline
Registration Number
NCT03040167
Lead Sponsor
Pierre Beaulieu
Brief Summary

The pectoral block is a recently developed regional anesthetic technique that can be used for the treatment of postoperative pain after breast surgery. Injection of local anesthetic between the major and the minor pectoral muscles is defined as the pectoral (PEC) 1 block. This block has not been well characterized in terms of its blocking effects on motor and sensitive nerves (medial and lateral pectoral nerves and intercostal nerves). This clinical trial is divided into two sections: a volunteer study and a patient study.

For the volunteer study, the aim is to assess the sensory territory affected by injection of local anesthetics through a PEC 1 block and to assess motor function in terms of strength of adduction of the affected limb using a dynamometer.

In a prospective, randomized, controlled and double blind study, the aim is to assess the postoperative pain relieving properties of the PEC 1 block in patients undergoing bilateral breast augmentation surgery.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
20
Inclusion Criteria
  • breast augmentation surgery
  • registration at régie d'assurance maladie du Québec (RAMQ) (social services)
Exclusion Criteria
  • known bleeding disorder
  • anticoagulant intake
  • infection at site of PEC 1 block
  • pregnant or breast-feeding women
  • allergy to bupivacaine
  • chronic pain including fibromyalgia with regular analgesic consumption
  • under recreational drugs or alcohol at doses above canadian recommendations
  • muscle relaxants intake
  • patients already operated for breast augmentation or mastectomy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control groupPEC 1 blockPEC 1 block with injection of 0.4 mL/kg of normal saline under echoguidance.
Control groupNormal salinePEC 1 block with injection of 0.4 mL/kg of normal saline under echoguidance.
Treatment groupPEC 1 blockPEC 1 block with injection of 0.4 mL/kg of 0.25% bupivacaine with 1/400 000 epinephrine under echoguidance.
Treatment groupBupivacaine with epinephrinePEC 1 block with injection of 0.4 mL/kg of 0.25% bupivacaine with 1/400 000 epinephrine under echoguidance.
Primary Outcome Measures
NameTimeMethod
Postoperative pain score at restWithin the first 10 min after arrival to the postanesthesia care unit (PACU)

Pain score using a verbal numerical scale (0-10) in one breast (bupivacaine) compared to the other breast (placebo)

Secondary Outcome Measures
NameTimeMethod
Postoperative well-beingAt 24 hours after surgery

Analgesic intake

Postoperative pain score on movementWithin the first 10 min after arrival to the postanesthesia care unit (PACU)

Pain score using a verbal numerical scale (0-10) in one breast (bupivacaine) compared to the other breast (placebo)

Postoperative pain score at rest15 min, 30 min, 60 min, 12h and 24 h after time of arrival in the PACU and immediately after discharge from PACU

Pain score using a verbal numerical scale (0-10) in one breast (bupivacaine) compared to the other breast (placebo)

Incidence of nausea and/or vomiting15 min, 30 min, 60 min, 12h and 24 h after time of arrival in the PACU and immediately after discharge from PACU

Presence or absence of nausea and/or vomiting

Surgical bleedingAfter surgery for 24 hours

Presence or not of surgical bleeding from wounds, drains eventually leading to surgical exploration

HematomaAfter surgery for 24 hours

Presence or absence of hematoma at PEC 1 block injection

Trial Locations

Locations (2)

CHUM

🇨🇦

Montreal, Quebec, Canada

CISSS des Laurentides

🇨🇦

Saint Jérôme, Quebec, Canada

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