Analgesic Benefits of the Novel Mid-point Transverse Process to Pleura (MTP) Block for Ambulatory Breast Cancer Surgery: A Randomized Controlled Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Enrollment
- 150
- Locations
- 1
- Primary Endpoint
- Postoperative analgesia during the first 24 hours.
Study Overview
Brief Summary
This study will compare the analgesic effects of midpoint transverse process to pleura (MTP) block to control as well as thoracic paravertebral block.
Detailed Description
Paravertebral blocks (PVBs) are frequently used for regional anesthesia for breast surgery. Ultrasound-guided paravertebral block is an advanced skill. The needle tip can be difficult to visualize with ultrasound, and the proximity to neurovascular structures as well as the pleura presents a risk of neurovascular injection and pneumothorax respectively. The midpoint transverse-process to pleura (MTP) block incorporates a novel needle endpoint that is technically easier to achieve and more distant from neurovascular structures and the pleura compared to traditional PVB. This study will compare the analgesic effects of MTP block to control and PVB.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description
Quadruple (participant, care provider, investigator, outcomes assessor)
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- Female
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •English or French Speaking
- •Scheduled for major breast surgery
- •ASA physical status classification I-III
- •BMI <30kg/m2
Exclusion Criteria
- •Prior ipsilateral breast surgery
- •Pre-existing neurological deficit or peripheral neuropathy involving the ipsilateral chest
- •Contraindications to regional anesthesia
- •Patient refusal of regional technique
- •Chronic pain disorder
- •Chronic opioid use
- •Inability to provide informed consent
Arms & Interventions
PVB group
paravertebral blocks with 0.5% ropivacaine and epinephrine 2.5 mcg/mL
Intervention: PVB group (Procedure)
MTP block group
MTP blocks with 0.5% ropivacaine and epinephrine 2.5 mcg/mL
Intervention: MTP block group (Procedure)
control group
local anesthetic infiltration subcutaneous 1% lidocaine
Intervention: Control Group (Procedure)
Outcomes
Primary Outcomes
Postoperative analgesia during the first 24 hours.
Time Frame: 48 hours
Measured by opioid (equivalents of morphine) consumption and pain scores on a numerical rating scale.
Secondary Outcomes
- Post-operative quality of recovery during the first 24 hours.(48 hours)