Anaesthesia to reduce pain after breast surgery

Not yet recruiting

Conditions: Medical and Surgical,

Registration Number: CTRI/2022/07/044423

Lead Sponsor: All India Institute of Medical Sciences

Brief Summary: Breast cancer is the most frequent cancer among Indian women accounting for 25 to 32 per cent. Surgical resection of the primary tumour with axillary dissection is one of the most important therapeutic procedures for breast cancer. Most breast surgeries are done in general anaesthesia, with or without regional blocks. Forty per cent of women experience moderate to severe pain following breast cancer surgery in the first few days.

Various regional anaesthesia techniques including thoracic paravertebral block, Erector spinae plane block, PEC block etc. have been used for perioperative analgesia in breast cancer surgery to decrease opioid consumption and its side effect. Poor management of acute postoperative pain may lead to persistent postoperative pain with an incidence of 25 to 60% of patients. These blocks are found to be effective for postoperative analgesia and also decrease the incidence of post-mastectomy pain syndrome. The paravertebral block is considered the gold standard for breast surgery but this block is associated with many complications. Recently interfacial blocks (pectoral nerve blocks) have been used for post-op analgesia in breast surgery.

This study aims to compare the efficacy of ultrasound-guided combined pectoral nerve block and pecto intercostal fascial block with thoracic paravertebral block for perioperative analgesia for MRM, and to find which requires less opioid consumption, better NRS, fewer complications, a better patient satisfactory score.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: Female

Target Recruitment: 50

Inclusion Criteria

Adult aged between 30-70 Yrs.
Posted for unilateral MRM 3.

Exclusion Criteria

Patients refusal 2.
Sensitivity to LA 3.
Bleeding disorders 4.
patients on anticoagulants 5.
BMI of more than 35 kg/m2 6.
Spine/chest wall deformity 7.
Pregnancy 8.
Inability to understand NRS and PCA device use 9.
Current chronic opioids use.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Time for first rescue analgesia noted in minutes/hours	Not applicable

Secondary Outcome Measures

Name	Time	Method
Complication	Patient satisfactory score
Total opioid consumption	first 24 hour
Postoperative morphine consumption in the first 24 hours	End of post operative 24 hour
Post-operative NRS on rest and movement	0,1,2,4,6,12,24 hour post surgery

Trial Locations

Locations (1): All India Institute of Medical Sciences, Patna
🇮🇳
Patna, BIHAR, India
All India Institute of Medical Sciences, Patna
🇮🇳Patna, BIHAR, India
Adarsh M Sheshagiri
Principal investigator
7026748639
msadarsh256@gmail.com