Pecs II Block and PaB Could be an Alternative in Breast Surgery

Study Overview
=================
Brief Summary
-----------------
The association between ultrasound-guided Pecs II block and parasternal block can represent a valid alternative in the management of acute and postoperative pain syndrome after quadrantectomy with or without axillary dissection.

Detailed Description
-----------------
The combination of Pecs II block and PaB provides good management of postoperative pain and can be considered a viable alternative to common anesthetic procedures performed for breast cancer surgery.

Official Title
-----------------
Association Between Ultrasound-guided Pecs II Block and Parasternal Block May Represent a Valid Alternative for the Management of Acute and Postoperative Pain Syndrome in Breast Cancer Surgery: a Retrospective Study

Conditions
-----------------
Breast Cancer

Intervention / Treatment
-----------------
* Procedure: Pecs II and parasternal blocks


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: 18-75 years of age; American Society of Anesthesiologists (ASA) physical status I-III, patients scheduled for quadrantectomy with or without axillary dissection Exclusion Criteria: pregnancy; body mass index (BMI) >35; allergy to local anesthetics; skeletal or muscle abnormalities of the chest wall; presence of primary or secondary neurological diseases; presence of psychiatric diseases; history of chronic pain or neuropathic disorders; history of drug abuse; state of sepsis; infection tumors of the skin on the chest; primary; secondary coagulopathies

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pecs II and parasternal blocks<br>Pecs II block was performed at the level of the fourth rib in the fascial plane between the minor pectoral and serratus anterior muscles, and 20 ml of 0.5% levobupivacaine solution were injected. An ultrasound-guided ipsilateral PaB was performed via two separate injections of 4 ml of 0.375% levobupivacaine at the level of the 2nd and 4th intercostal space underneath the external intercostal membrane between the major pectoral and intercostal muscles close to the surface of the 2nd and 4th rib. | Procedure: Pecs II and parasternal blocks<br>* Pecs II block was performed at the level of the fourth rib in the fascial plane between the minor pectoral and serratus anterior muscles, and 20 ml of 0.5% levobupivacaine solution were injected. An ultrasound-guided ipsilateral parasternal block was performed via two separate injections of 4 ml of 0.375% levobupivacaine at the level of the 2nd and 4th intercostal space underneath the external intercostal membrane between the major pectoral and intercostal muscles close to the surface of the 2nd and 4th rib.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain | Pain has been evaluate with visual analogue scale (VAS) at 24 months after surgery | Pain was recorded at 24 months after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neuropathic postoperative disturbances | Neuropathic postoperative disturbances were examined using the von Frey hair test (neuropathic disturbances: present/not present) at 24 months | Neuropathic postoperative disturbances were recorded at 24 months after surgery | 
| Patient satisfaction | Patient satisfaction with regard to the anesthetic procedure was assessed using a five-step satisfaction scale (not at all/slightly/somewhat/very/extremely satisfied). | Patient satisfaction was evaluated at 1 day after surgery | 
| Woud healing | Wound healing was assessed using a three-step scale (unacceptable/acceptable/excellent healing) in accordance with the surgeon's opinion. | Wound healing was assessed at 24 months after surgery |