Analgesic Effect to Postoperative Pain After Mastectomy: Ultrasound-guided Serratus Anterior Plane Block

Study Overview
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Brief Summary
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Ultrasound guided serratus anterior plane block may decrease acute postoperative pain and consumption of opioid after mastectomy.

Conditions
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Breast Cancer

Intervention / Treatment
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* Drug: Ultrasound guided serratus anterior block with ropivacaine
* Drug: intravenous PCA only


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA 1 3 Age 20 80 Breast cancer patient twho are scheduled for elective mastectomy Exclusion Criteria: Allergy to local anesthetics or contraindication to use of ropivacaine Pregnancy Severe cardiovascular disease Renal failure Liver failure Neurologic and psychologic disease Chronic treatment with analgesics Previous history of mastectomy or thoracic surgery.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group S<br> | Drug: Ultrasound guided serratus anterior block with ropivacaine<br>* After induction of anesthesia, patients take ultrasound guided serratus anterior plane block with 0.5ml/kg of ropivacaine 0.375%. 30minutes before the end of operation, intravenous patient controlled analgesia (Basal rate 0ml/hr, 0.5mcg/kg of fentanyl, lock-out time 10minutes) is connected to patient.<br>|
| Placebo Comparator: Group C<br> | Drug: intravenous PCA only<br>* same dose of intravenous patient controlled analgesia (Basal rate 0ml/hr, 0.5mcg/kg of fentanyl, lock-out time 10minutes) is connected to patient only.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total opioid consumption | Assessing total opioid consumption (total number of bolus injection and total dose of fentanyl via intravenous patient controlled analgesia) within 24hours after operation finished. | within 24 hrs after mastectomy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain scale (Numeric rating scale 0-10) at PACU |  | chang from 3,6,12,24 to 48hrs after operation end | 
| Total intraoperative remifentanil consumption(mcg) |  | within 24 hrs after mastectomy | 
| Additional analgesics requirements (dose/number) |  | within 24 hrs after mastectomy | 
| incidence and intensity of postoperative nausea and vomiting(NRS:0-10) |  | within 24 hrs after mastectomy | 
| Total hospital staying time |  | within 24 hrs after mastectomy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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breast cancer, serratus anterior block, ultrasound, postoperative pain