Pecs II Block and PaB Could be an Alternative in Breast Surgery

Association Between Ultrasound-guided Pecs II Block and Parasternal Block May Represent a Valid Alternative for the Management of Acute and Postoperative Pain Syndrome in Breast Cancer Surgery: a Retrospective Study

The association between ultrasound-guided Pecs II block and parasternal block can represent a valid alternative in the management of acute and postoperative pain syndrome after quadrantectomy with or without axillary dissection.

Study Overview

• Status: Completed
• Conditions: Breast Cancer
• Intervention / Treatment: Procedure: Pecs II and parasternal blocks

Detailed Description

The combination of Pecs II block and PaB provides good management of postoperative pain and can be considered a viable alternative to common anesthetic procedures performed for breast cancer surgery.

• Study Type: Observational
• Enrollment (Actual): 180

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

• Sampling Method: Probability Sample

Study Population

Patients scheduled for quadrantectomy with or without axillary dissection.

Description

Inclusion Criteria:

• 18-75 years of age;
• American Society of Anesthesiologists (ASA) physical status I-III,
• patients scheduled for quadrantectomy with or without axillary dissection

Exclusion Criteria:

• pregnancy;
• body mass index (BMI) >35;
• allergy to local anesthetics;
• skeletal or muscle abnormalities of the chest wall;
• presence of primary or secondary neurological diseases;
• presence of psychiatric diseases;
• history of chronic pain or neuropathic disorders;
• history of drug abuse;
• state of sepsis;
• infection
• tumors of the skin on the chest;
• primary;
• secondary coagulopathies

Study Plan

How is the study designed?

Design Details

• Time Perspectives: Retrospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Pecs II and parasternal blocks; Pecs II block was performed at the level of the fourth rib in the fascial plane between the minor pectoral and serratus anterior muscles, and 20 ml of 0.5% levobupivacaine solution were injected. An ultrasound-guided ipsilateral PaB was performed via two separate injections of 4 ml of 0.375% levobupivacaine at the level of the 2nd and 4th intercostal space underneath the external intercostal membrane between the major pectoral and intercostal muscles close to the surface of the 2nd and 4th rib.

Procedure: Pecs II and parasternal blocks; Pecs II block was performed at the level of the fourth rib in the fascial plane between the minor pectoral and serratus anterior muscles, and 20 ml of 0.5% levobupivacaine solution were injected. An ultrasound-guided ipsilateral parasternal block was performed via two separate injections of 4 ml of 0.375% levobupivacaine at the level of the 2nd and 4th intercostal space underneath the external intercostal membrane between the major pectoral and intercostal muscles close to the surface of the 2nd and 4th rib.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain	Pain has been evaluate with visual analogue scale (VAS) at 24 months after surgery	Pain was recorded at 24 months after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neuropathic postoperative disturbances	Neuropathic postoperative disturbances were examined using the von Frey hair test (neuropathic disturbances: present/not present) at 24 months	Neuropathic postoperative disturbances were recorded at 24 months after surgery
Patient satisfaction	Patient satisfaction with regard to the anesthetic procedure was assessed using a five-step satisfaction scale (not at all/slightly/somewhat/very/extremely satisfied).	Patient satisfaction was evaluated at 1 day after surgery
Woud healing	Wound healing was assessed using a three-step scale (unacceptable/acceptable/excellent healing) in accordance with the surgeon's opinion.	Wound healing was assessed at 24 months after surgery

Collaborators and Investigators

• Sponsor: Emiliano Petrucci

Study record dates

Study Major Dates

• Study Start: March 1, 2013
• Primary Completion (Actual): March 1, 2013
• Study Completion (Actual): December 1, 2015

Study Registration Dates

• First Submitted: August 4, 2016
• First Submitted That Met QC Criteria: August 9, 2016
• First Posted (Estimate): August 12, 2016

Study Record Updates

• Last Update Posted (Estimate): August 12, 2016
• Last Update Submitted That Met QC Criteria: August 9, 2016
• Last Verified: August 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Skin Diseases; Neoplasms; Neoplasms by Site; Breast Diseases; Breast Neoplasms
• Other Study ID Numbers: 0109060/16

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No