Effect of Pectoral Nerve Block on Post-op Pain in Patients Undergoing Mastectomy and Immediate Reconstruction
Breast Neoplasm
About this trial
This is an interventional treatment trial for Breast Neoplasm
Eligibility Criteria
Inclusion Criteria:
- Patients age 18-90 years old
- Subjects able to read and understand the informed consent
- American Society of Anesthesiologists (ASA) physical status I and II
Subjects scheduled to undergo unilateral or bilateral mastectomy with immediate breast reconstruction with submuscular placement of tissue expander or permanent implant under general anesthesia, including:
- subjects diagnosed with breast cancer
- subjects diagnosed with atypia or other high risk proliferative breast disease
- subjects with a family history who are considered at high risk for breast cancer (including those with hereditary or genetic predisposition)
Exclusion Criteria:
- Subjects unable to read or understand the informed consent
- ASA physical status III or IV
- Subjects with an allergy to local anesthetic
- Subjects with a medical contraindication to regional anesthetic, such as coagulopathy or local infection
- Subjects with a pre-existing submuscular implant
- Subjects scheduled to undergo mastectomy with myocutaneous flap reconstruction
- Subjects scheduled to undergo mastectomy without immediate reconstruction
- Subjects with a history of chronic pain or chronic opioid use
Sites / Locations
- Huntington Memorial HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
GA + Pec Block
GA only
Following induction of general anesthesia, the patients in the intervention group will undergo an ultrasound-guided pectoral block. With the patient in proper position, the infraclavicular and axillary regions are prepped with chlorhexidine. An US probe is placed below the third of the clavicle over the pectoralis major muscle. After identifying the appropriate anatomical structures, a 21-gauge echogenic needle is advanced under US visualization to the tissue plane between the pectoral major and pectoral minor muscles where the lateral and medial pectoralis nerves lie and 15 mL of 0.25% bupivacaine will be deposited. In a similar manner, 20 mL of 0.25% bupivacaine will be deposited under ultrasound-guidance at the level of the third rib above the serratus anterior muscle.
Patients will receive standard general anesthesia.