Transversus Thoracic Muscle Plane Combined With Pectoral Nerves Block for Breast Cancer Surgery

Zhejiang Cancer Hospital116 enrolled

Overview

This is a prospective, randomized, controlled trial for evaluating the efficacy of addition of transversus thoracic muscle plane block to pectoral nerves block versus pectoral nerves block for quality of recovery scores in breast cancer surgery.

The pectoral nerves (PECS) block cannot block the most internal mammary region, whereas a transversus thoracic muscle plane (TTP) block can. The combination of PECS and TTP blocks may be suitable for breast cancer surgery. We studied patients undergoing breast cancer surgery to assess whether the combination of PECS and TTP blocks provides better postoperative recovery than PECS block alone.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

116

Conditions

Breast Cancer

Interventions

the combination of transversus thoracic muscle plane and pectoral nerves blocksPROCEDURE

For the pectoral nerves block, 0.375% ropivacaine , 10ml was injected between the pectoralis major and pectoralis minor and 20 ml above the serratus anterior muscle. For the transversus thoracic muscle plane block, ropivacaine 0.375%,15ml was injected between the transversus thoracic muscle and the internal intercostal muscle.

the pectoral nerves block onlyPROCEDURE

For the pectoral nerves block, 0.375% ropivacaine , 10ml was injected between the pectoralis major and pectoralis minor and 20 ml above the serratus anterior muscle.

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * female, 18-80 years of age * American Society of Anesthesiologists physical status I-III * patients having elective unilateral breast cancer surgery Exclusion Criteria: * contraindication to nerve block * inability to understand or communicate with research personnel * chronic use of opioids or nonsteroidal anti-inflammatory drugs * pregnancy

Locations (1)

Zhejiang Cancer Hospital

Hangzhou, Zhejiang, China

Outcomes

Primary Outcomes

the quality of recovery-15 questionnaire (QoR-15)

The QoR-15 is a validated short-form postoperative quality of recovery score. Fifteen questions assess five domains of patient health-related quality of life: pain; comfort; physical independence; psychological support; and emotional state. Each question uses an 11-point rating scale, in which the maximum score is 150, denoting excellent recovery. 1. Able to breathe easily 2. Been able to enjoy food 3. Feeling rested 4. Have had a good sleep 5. Able to look after personal toilet and hygiene unaided 6. Able to communicate with family or friends 7. Getting support from hospital doctors and nurses 8. Able to return to work or usual home activities 9. Feeling comfortable and in control 10. Having a feeling of general well-being 11. Moderate pain 12. Severe pain 13. Nausea or vomiting 14. Feeling worried or anxious 15. Feeling sad or depressed

Time frame: at 24 hours after surgery

Secondary Outcomes

NRS score for rest and coughing pain

Postoperative pain at rest and during coughing was assessed by NRS score with a range of 0 to 10 (0=no pain, 10=the worst possible pain)

Time frame: at 1, 6, 24, 48 hours after surgery

consumption of opioid converted to IV morphine equivalents

opioids given postoperatively converted to IV morphine equivalents

Time frame: during 24 hours after surgery

the incidence of postoperative hypotension

Adverse reactions related to opioid

Time frame: during 48 hours after surgery

the incidence of nausea and vomiting

Adverse reactions related to opioid

Time frame: during 48 hours after surgery

the incidence of pruritus

Data from ClinicalTrials.gov

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