PECS II vs. MTP for Analgesia After MRM
- Conditions
- Breast Neoplasm FemalePostoperative Pain Management
- Registration Number
- NCT06187909
- Lead Sponsor
- Ain Shams University
- Brief Summary
This randomized controlled study aims to compare the analgesic efficacy of the ultrasound-guided modified pectoral nerve block (PECS II) and the midpoint transverse process to pleura (MTP) block in female patients undergoing modified radical mastectomy (MRM). Postoperative pain intensity will be assessed using the Visual Analog Scale (VAS) over the first 24 hours, with additional evaluation of opioid consumption and complications.
- Detailed Description
Modified radical mastectomy (MRM) is associated with significant postoperative pain, which may increase opioid use, delay recovery, and contribute to chronic post-mastectomy pain syndrome. This study compares two regional analgesic techniques: the ultrasound-guided modified pectoral nerve block (PECS II) and the midpoint transverse process to pleura (MTP) block.
The PECS II block involves the injection of local anesthetic between the pectoralis minor and serratus anterior muscles, targeting the pectoral nerves and lateral cutaneous branches of intercostal nerves (T2-T6). It is widely used for anterior chest wall analgesia after breast surgery. The MTP block, a more recent paravertebral-domain technique, deposits anesthetic midway between the transverse process and the pleura, allowing spread to dorsal and ventral rami via the superior costotransverse ligament and potentially achieving broader thoracic segment coverage.
This randomized trial evaluates postoperative pain control using the Visual Analog Scale (VAS) over 24 hours, along with opioid consumption and adverse events. The aim is to determine whether the MTP block offers superior analgesia and an opioid-sparing effect compared to the PECS II block.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 88
- Female patients scheduled for modified radical mastectomy (MRM).
- Age between 40 and 65 years.
- American Society of Anesthesiologists (ASA) physical status I-II.
- Known allergy to local anesthetics.
- Coagulopathy.
- Infection at the site of injection.
- Patient refusal.
- Inability to understand or use the pain scale.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Post-operative Pain Severity Assessed by VAS at Zero Time (on Admission to the PACU) will be evaluated post-operatively at zero time Visual Analogue Scale is a scale for pain assessment ranging from 0 to 10 where 0 is minimum and means no pain while 10 is maximum and means maximum pain which means worse outcome
- Secondary Outcome Measures
Name Time Method Post-operative Pain Severity Assessed by VAS at Hour-2, Hour-4, Hour-8, Hour-12, Hour-18 and Hour-24. 24 hours postoperatively Comparison between postoperative pain severity after 2 hours, 4 hours, 8 hours, 12 hours, 18 hours and 24 hours postoperative between both groups using visual analogue score Visual Analogue Scale is a scale for pain assessment ranging from 0 to 10 where 0 is minimum and means no pain while 10 is maximum and means maximum pain which means worse outcome
Time of First Rescue Analgesia 24 hours postoperatively Comparison between both groups regarding the time of first needed dose of nalbuphine
Cumulative Post-operative Nalbuphine Consumption in the First 24 Hours 24 hours postoperatively Comparison between both groups regarding total consumed nalbuphine in first 24 hours postoperative
Incidence of Postoperative Side Effects and Complications 24 hours postoperatively Comparison between both groups regarding postoperative side effects and complications
Trial Locations
- Locations (1)
Ain Shams University
🇪🇬Cairo, Egypt
Ain Shams University🇪🇬Cairo, Egyptfatma ebeidContact