Anesthetic Efficacy of PECS II Block and Parasternal Block

Study Overview
=================
Brief Summary
-----------------
The study evaluate the anesthetic efficacy of Pecs II block II and parasternal block during quadrantectomy with or without axillary dissection, in breast cancer surgery

Detailed Description
-----------------
All patients receive Pecs II block and parasternal block, under ultrasound guidance. Pecs II block, performed at the 4th rib level, and parasternal block performed at the level of the 2nd and 4th intercostal space level. Data on the anesthesia, side effects and pain, will be recorded

Official Title
-----------------
Anesthetic Efficacy of PECS II Block and Parasternal Block for Quadrantectomy With or Without Axillary Dissection

Conditions
-----------------
Anesthesia, Local

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


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: patients who need of quadrantectomy with or without axillary dissection ASA I-III patients age between 18 and 75 years filled informed consent Exclusion Criteria: pregnant women obesity (BMI > 39,99) radical mastectomy ASA IV patients chest wall abnormalities neurological disorders septic status chest skin infections 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?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pecs II block and parasternal block<br>Pecs II block and parasternal block performed to provide anesthesia of breast, before of quadrantectomy with or without axillary dissection. Pecs II block performed at the 4th rib level and 20 ml of 0.5% Levobupivacaine injected, and parasternal block performed at the level of the 2nd and 4th intercostal space level, and 4 ml of 0.375% Levobupivacaine injected | Procedure: Pecs II block and parasternal block<br>* The Pecs II block will be performed under ultrasound guidance, at fourth rib level, on the axillary line, into the fascial plane between pectoralis minor muscle and serratus muscle. The parasternal block will be performed under ultrasound guidance, at the second and fourth intercostal space, between the pectoralis major muscle and the intercostal muscles, near to the external intercostal membrane.<br>|

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

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anesthetic efficacy | The anesthetic efficacy is tested by cold and touch test | The anesthetic efficacy was assessed in the first 72 hours, after block | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Painkillers request | mg of morphine | The painkillers request was assessed in the first 72 hours, after surgery | 
| Side effects | Nausea, vomiting, local anesthetic systemic toxicity | The side effects recorded in the first 72 hours, after surgery |