Breast Cancer Clinical Trial
Paravertebral Block Versus Pectoral Nerve Block
Summary
The purpose of this study is to compare two standard methods of pain control management used at Spectrum Health for patients undergoing breast surgery. The two methods being compared are the paravertebral block and the pectoral nerve block. Postoperative pain control is essential following any major operative procedure. A variety of methods have been utilized to ensure adequate analgesia, each with its own advantages and risks. Increasingly, attention has focused on regional methods of analgesia, which may allow for reduction in systemic narcotic use and their associated complications. Proposed benefits of regional analgesia and a resultant reduction in narcotic use include decreased risk of cancer progression, decreased length of stay, and decreased risk of ileus.
Full Description
The purpose of this study is to compare the clinical profiles of two currently acceptable analgesia techniques. The most common regional block used to achieve postoperative analgesia following mastectomy is the paravertebral block, during which local anesthetic is injected into the paravertebral space which contains the thoracic spinal nerves, between the costotransverse ligament and the pleura. At our institution there has been recent interest in an alternative regional block. The pectoral nerve block is performed by injecting anesthetic between the pectoralis major and the pectoralis minor (PECs I) or between the pectoralis minor and the serratus anterior (PEC II).
The proposed advantage of the pectoral nerve block for regional anesthesia during breast surgery is equal analgesic efficacy with fewer potential complications.
Eligibility Criteria
Inclusion Criteria:
Female patients ≥ 18 years of age
Total mastectomy or partial mastectomy with or without reconstruction OR planned lumpectomy.
Patient determined by their surgeon as medically able to receive a regional block for post-operative analgesia
Patient agrees to participate in the study and signs informed consent
Exclusion Criteria:
Neoadjuvent radiation therapy
Stage IV cancer
Previous breast surgery (excluding percutaneous biopsies of all types)
History of either PVB or PEC procedures
Planned general anesthesia use during surgery
Allergies to ropivacaine, midazolam, fentanyl, or propofol
Pregnant women
Prisoners
Adults unable to consent
Non-English-speaking patients
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