Erector Spinae Plane Block Versus Paravertebral Block in Mastectomy
Postoperative Pain
About this trial
This is an interventional treatment trial for Postoperative Pain focused on measuring regional anesthesia, postoperative pain, mastectomy, erector spinae plane block, paravertebral block
Eligibility Criteria
Criteria for Inclusion of Subjects:
- Female and male ASA physical status 1-3 scheduled for unilateral total mastectomy without immediate reconstruction
- Age 18-80 years old
- Able to participate personally or by legal representative in informed consent in English or Spanish
Criteria for Exclusion of Subjects:
- History of relevant drug allergy
- Age less than 18 or greater than 80 years
- Chronic opioid use or drug abuse
- Significant psychiatric disturbance
- Inability to understand the study protocol
- Refusal to provide written consent
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Paravertebral Block
Erector Spinae Plane Block
For this arm, the initial level will be at T3-4 and an out-of-plane technique to guide the needle tip to a point between the costotransverse ligament and the parietal pleura between the visualized transverse processes. Then, a few milliliters of 0.5% ropivacaine will be injected slowly to displace the pleura ventrally as the paravertebral space fills with local anesthetic. After negative aspiration, the rest of 0.5% ropivacaine (total 10 ml) will be injected in 5 ml increments to further fill the paravertebral space. The procedure will then be repeated in the same exact fashion at the T5-6 level. We will observe local anesthetic spread under real-time ultrasound imaging.
For this arm, the needle tip will be directed under ultrasound guidance using an in-plane technique towards the T5 transverse process until the needle tip contacts os. Then, a few milliliters of ropivacaine will be injected slowly to separate the plane between the erector spinae muscle and the transverse process. After negative aspiration, the rest of the 0.5% ropivacaine will be injected (total 20ml)