Clinical trial NCT06419504: The Effect of Ultrasonography-guided Fascial Plane Blocks in Breast Cancer Surgery Patients
Official title: The Effect of Ultrasonography-guided Pectoserratus Plane Block, Erector Spina Plane Block and Serratus Anterior Plane Block on Postoperative Opioid Consumption, Recovery Quality and Chronic Pain in Breast Cancer Surgery Patients
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Breast Cancer
Keywords: regional anesthesia
postoperative pain
recovery quality
chronic pain
breast cancer
Lead sponsor: Antalya Training and Research Hospital
Sponsor class: OTHER_GOV
First posted: 2024-05-17
Enrollment: 96
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: It is planned to include ASA I-III patients between the ages of 18-65 who are planned to undergo breast cancer surgery

Brief summary: The aim of this study was to evaluate the efficacy of serratus anterior plane (SAP) block, pectoserratus plane (PECS II) block, and erector spinae plane (ESP) block on postoperative acute pain, quality of recovery and chronic pain in breast cancer surgery patients.

Detailed description: Breast cancer is the most common type of cancer in women. Although surgical treatment is effective and curative, it is associated with many complications in the postoperative period. Acute pain after surgery is one of them. Approximately half of women undergoing breast surgery describe significant post-operative pain (\>5 on the Visual Analogue Scale; VAS) score that is not always effectively controlled by standard post-operative treatments. Poorly controlled postoperative pain has been associated with impaired functional recovery, delayed discharge from the post-anesthetic care unit, and prolonged hospital stay. In addition, poorly managed acute pain becomes chronic and is described as 'post-mastectomy pain syndrome'. Regional techniques can reduce acute and chronic postoperative pain. The development of ultrasonography (US)-guided regional anesthesia has led to the development of fascial plane blocks. Serratus anterior plan (SAP) block, pectoserratus plan (PECS II) block, and erector spina plan (ESP) block are frequently used for postoperative analgesia in patients undergoing breast surgery. he aim of this study was to evaluate the efficacy of serratus anterior plane (SAP) block, pectoserratus plane (PECS II) block, and erector spinae plane (ESP) block on postoperative acute pain, quality of recovery and chronic pain in breast cancer surgery patients.

Eligibility criteria: Inclusion Criteria:

* elective breast surgery (modified radical mastectomy, breast conserving surgery, simple mastectomy, axillary lymph node dissection, etc.),
* 18 to 65 years old,
* American Society of Anaesthesiology (ASA) score I-III
* body mass index (BMI) \<32 kg/m2

Exclusion Criteria:

* contraindications to the block applications
* history of mental or neurological disorders
* history of chronic opioid use
* chronic alcoholism
* substance use
* treatment of chronic pain
* severe liver and kidney disease
* uncooperative patients
* patients scheduled for bilateral mastectomy

Primary outcomes:
measure: postoperative opioid consumption
timeFrame: 24 hours
Secondary outcomes:
measure: recovery quality
timeFrame: 5 minutes
measure: chronic pain
timeFrame: 3 months
Other outcomes:
Locations:
city: Antalya
country: Turkey
facility: University of Health Sciences, Antalya Training and Researh Hospital
state: Muratpaşa
Study officials:
affiliation: University of Health Sciences, Antalya Training and Researh Hospital
name: Hafizenur O Atalay, M.D.
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Health Sciences, Antalya Training and Researh Hospital
name: Arzu O Karaveli, M.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Wang S, Shi J, Dai Y, Zhang J, Liu Q, Yang P, Zhu N. The effect of different nerve block strategies on the quality of post-operative recovery in breast cancer patients: A randomized controlled study. Eur J Pain. 2024 Jan;28(1):166-173. doi: 10.1002/ejp.2178. Epub 2023 Sep 1.
citation: Fujii T, Shibata Y, Akane A, Aoki W, Sekiguchi A, Takahashi K, Matsui S, Nishiwaki K. A randomised controlled trial of pectoral nerve-2 (PECS 2) block vs. serratus plane block for chronic pain after mastectomy. Anaesthesia. 2019 Dec;74(12):1558-1562. doi: 10.1111/anae.14856. Epub 2019 Sep 19.