The purpose of this study is to determine whether pectoral nerves blocks(PECS) would reduce chronic pain at 3 months after modified radical mastectomy(MRM)surgery.
One hundred and forty adult female participants scheduled for elective unilateral modified radical mastectomy under general anesthesia are randomly allocated to receive either general anesthesia plus Pecs block(Pecs group, n=70) or general anesthesia alone (control group, n=70). After arrived in the operating room,the participants in the control group are accepted the general anesthesia.Whereas,after anesthesia induction,the participants in the Pecs group receive an ultrasound-guided Pecs block and a 15 minute observation time prior before the start of the operation. Pecs block technology: A broadband (5-12 hertz) linear array probe of Sonosite Edge portable ultrasound system (Sonosite Inc,Bethel,Washington) is used, with an imaging depth of 4 to 6 cm. After cleaning the infraclavicular and axillary regions with chlorhexidine, the probe is placed below the lateral third of the clavicle, similar to what is done when performing infraclavicular brachial plexus block. After recognition of the appropriate anatomical structures, the skin puncture point is infiltrated with 2% lignocaine, then the block is performed by using a 20-gauge Tuohy needle. The needle is advanced to the tissue plane between the pectoralis major and pectoralis minor muscle at the vicinity of the pectoral branch of the acromiothoracic artery, and 10 mL of 0.35% ropivacaine deposited. In a similar manner, 20 mL is deposited at the level of the third rib below the serratus anterior muscle with the intent of spreading injectate to the axilla.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
140
Local injection of local anesthetic into the fascial spaces
Sodium chloride solution commonly used in clinical which equal to human plasma osmotic pressure.
First Affiliated Hosipital of Xi'an Jiaotong Univercity
Xi'an, Shaanxi, China
RECRUITINGThe incidence of chronic postoperative pain for 3 months after modified radical mastectomy surgery
An anesthesiologist interviews the patients by phone to determine the postoperative pain at 3 months after surgery. Chronic pain is defined as pain in the surgical area or the ipsilateral arm, present at least 4 days a week, with an intensity of 3 or more on the verbal rating scale(0=no pain to 10=worst imaginable pain),described as a typical neuropathic pain consisting of burning pain, shooting pain, pain evoked by pressure, and deep blunt pain.
Time frame: 3 months after modified radical mastectomy surgery
Postoperative Numerical Rating scale (NRS) score for pain
Pain scores(0-10)during rest and cough based on measurement at 0 hour postoperative.
Time frame: 0 hour postoperative
Postoperative Numerical Rating scale (NRS) score for pain
Pain scores(0-10)during rest and cough based on measurement at 4 hours postoperative.
Time frame: 4 hours postoperative
Postoperative Numerical Rating scale (NRS) score for pain
Pain scores(0-10)during rest and cough based on measurement at 12 hours postoperative.
Time frame: 12 hours postoperative
Postoperative Numerical Rating scale (NRS) score for pain
Pain scores(0-10)during rest and cough based on measurement at 24 hours postoperative.
Time frame: 24 hours postoperative
Postoperative Numerical Rating scale (NRS) score for pain
Pain scores(0-10)during rest and cough based on measurement at 48 hours postoperative.
Time frame: 48 hours postoperative
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Postoperative Numerical Rating scale (NRS) score for pain
Pain scores(0-10)during rest and cough based on measurement at 72 hours postoperative.
Time frame: 72 hours postoperative