The goal of this clinical trial is to is to compare the effectiveness of ultrasound-guided Pecs block with intravenous ketamine versus intravenous ketamine infusion alone in preventing Chronic Post-Surgical Pain (CPSP) in patients undergoing breast cancer surgery. The main question it aims to answer is, How effective is the ketamine and ketamine with pecs block in reducing the frequency of Chronic Post-Surgical Pain after breast cancer surgery
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
120
Before skin incision, a bolus 0.35 mg/kg ketamine will be given followed by a continuous infusion 0.25 mg/kg/hr. Ketamine infusion will be stopped 30 minutes before the end of the surgery
Pecs block will be performed before surgical incision with the help of an ultrasound (US) by experienced anesthesiologist. The drug used for the pecs block will be two syringes of 10ml and 20 ml containing bupivacaine 0.25% (total 30 ml).
Intravenous Nalbuphine 0.1 mg/kg
Intravenous Paracetamol 1g or 15mg/kg (if weight is \< 50kg).
Frequency of Chronic Post-operative Pain
Pain intensity will be assessed using an 11-point numeric rating scale (NRS) by an investigator blinded to group allocation. Scores range from 0 (no pain) to 10 (worst imaginable pain), with higher scores indicating greater pain severity and therefore a worse outcome. Data will be collected from patients in the breast clinic or via telephone at one week, 1,2, 3, and 6 months after surgery. All patients will be followed till six months after discharge from the hospital.
Time frame: Data will be collected from patients in the breast clinic or via telephone at one week, 1,2, 3, and 6 months after surgery.
Character of Chronic Post-Surgical Pain
Patients will be asked to describe the character(quality) of their pain (e.g., burning, sharp, pricking, electric-shock-like) during follow-up visits. patients will be subjectively asked to describe the quality of pain.
Time frame: Till six months after discharge from the hospital.
Duration of Chronic Post-Surgical Pain
From three months to six months.
Time frame: Till six months after discharge from the hospital.
Distribution of Chronic Post-Surgical Pain
Patients will be asked to report the location of any persistent pain during follow-up visits. Using a standardized body map diagram, they will indicate whether pain is present at the surgical site or in surrounding areas (e.g., axilla, upper arm, upper back, chest wall).
Time frame: Till six months after discharge from the hospital.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.