Regional analgesia technique in addition to multimodal analgesia in breast-conserving surgery aims to reduce opioid consumption. This study evaluates the postoperative analgesic efficacy of ultrasound-guided BRILMA block in patients undergoing breast conserving surgery.
Breast-conserving surgery has become a standard surgical approach in the management of early-stage breast malignancies. Despite being less invasive than other oncologic procedures, postoperative pain remains a significant concern. In postoperative pain management, the addition of regional analgesia techniques to multimodal approaches aims to reduce opioid consumption. First described in 2013, the Serratus-Intercostal Interfascial Plane block targets the branches of the intercostal nerves at the level of the mid-axillary line, specifically around the fourth rib-an anatomical region referred to by the acronym BRILMA. This regional anesthesia technique has demonstrated efficacy in managing postoperative pain, particularly after breast surgery. In the study, investigators planned to evaluate the postoperative analgesic efficacy of ultrasound-guided BRILMA block via 24-hour morphine consumption in patients undergoing breast conserving surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
20 ml 0.25 % bupivacaine was injected into the fascial plane between the serratus anterior muscle and the external intercostal muscle at T4 level.
Standard intravenous analgesia.
Istanbul University, Istanbul Faculty of Medicine
Istanbul, Turkey (Türkiye)
Morphine consumption
Amount of morphine consumption
Time frame: postoperative 24-hour
Static and dynamic pain scores assessed with numeric rating scale
pain scores recorded at 0., 1., 4., 8., 12., 24. hours postoperatively
Time frame: postoperative 24 hours
number of blocked dermatome
pinprick test in mid-axillary and mid-claviculary line
Time frame: 20. minute after block performance
Duration of block application
time from the insertion of probe to the removal of needle from skin
Time frame: up to 15 minutes
Amount of fentanyl for sedation. [Time Frame: Intraoperative 2-3 hours]
Amount fentanyl use during surgery
Time frame: during surgery
Rescue analgesia
number of patients needed rescue analgesia
Time frame: postoperative 24 hours
Nausea and vomit
postoperative nausea and vomiting (0=no, 1= mild nausea, 2= severe nausea or vomiting)
Time frame: postoperative 24 hours
Complications
Hematoma, vascular puncture, pneumothorax
Time frame: Up to 24 hours
Patient's satisfaction
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Likert scale:1-5 (1: very dissatisfied, 5: very satisfied)
Time frame: Up to 24 hours