- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06019325
Rhomboid Intercostal Plane Block on Chronic Pain Incidence and Acute Pain Scores After Mastectomy
September 28, 2023 updated by: Başak Altıparmak, Muğla Sıtkı Koçman University
The Effect of Single Shot Rhomboid Intercostal Plane Block on Chronic Pain Incidence and Acute Pain Scores After Mastectomy Surgery
Rhomboid intercostal block is used to block lateral cutaneous branches of intercostal nerves between T3 and T9 dermatomes.
RIB has been reported to be successful in attenuating acute pain following breast surgeries.
However, it's effect on chronic pain has not been evaluated yet.
The primary hypothesis of the study is that the incidence of chronic pain of the patients who will receive Rhomboid intercostal block (RIB) following breast cancer surgery will be lower than the patients who will receive no block intervention at the postoperative 3rd month.
The secondary hypothesis is that the incidence ofchronic pain of the patients who will receive Rhomboid intercostal block (RIB) following breast cancer surgery will be lower than the patients who will receive no block intervention at the postoperative 6th month.
An other secondary hypothesis is that the total BPI-SF scores will be lower in the RIB group than control group at the postoperative 3rd and the 6th months.
Study Overview
Status
Recruiting
Intervention / Treatment
Detailed Description
The study is designed as a prospective, double-blinded, randomize controlled study.
The patients who will undergo mastectomy surgery with or without axillary dissection will be included in the study.
Anesthesia will be inducted with intravenous (iv) thiopental 5 mg/kg, fentanyl 2 mcg/kg and rocuronium bromide 0.6 mg/kg.
Following intubation, patients will be allocated into two groups according to a randomization table created by a professional statistician.
In the study group, patients will receive a single shot Rhomboid Intercostal Block (RIB) with 30 milliliters of %0.25 bupivacaine and in the control group no block procedure will be performed.
All patients will receive a standard analgesia protocol which will include an intraoperative intravenous (iv) infusion of dexketoprofen 50 mg and iv tramadol 1 mg/kg 15 minutes prior to the end of the surgery.
Postoperative pain intensity of the patients will be evaluated by Numerical Rating Scale (NRS) which is a scale ranges between 0 (no pain) and 10 (the worst pain that a person can stand).
Pain scores of the patients will be recorded at the postoperative 15. and 30.
min in the recovery room and if the NRS score is 4 or more, iv fentanyl 1 mcg/kg will be applied.
At the surgical ward, pain scores will be evaluated at the postoperative 1st, 2nd, 6th, 12th and 24th hours and if the NRS score is 4 or more, iv tramadol 50 mg will be applied as rescue analgesia.
Opioid consumptions of the patients will be recorded at the postoperative 24th hour.
At the postoperative 3. and 6. months, a pain doctor will evaluate all patients by using Brief Pain Inventory Short Form (BPI-SF) and Douleur Neuropathique 4 (DN4) questionnaire.
Study Type
Interventional
Enrollment (Estimated)
254
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: BAŞAK ALTIPARMAK, Ass Prof
- Phone Number: +905326726533
- Email: basak_ugurlu@yahoo.com
Study Locations
-
-
Menteşe
-
Mugla, Menteşe, Turkey, 48000
- Recruiting
- Muğla Training and Research Hospital
-
Contact:
- BAŞAK ALTIPARMAK, ASSPROF
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- ASA I-II patients
- Female
- Ages between 18-65
- Patients who will receive breast cancer surgery under general anesthesia
Exclusion Criteria:
- Alcohol or substance or chronic opioid consumption story
- Any pain killers intake in the last 24 hours prior to surgery
- Body mass index over 35 kg/m2
- Infection at the injection sites
- Known allergy to local anesthetics
- Known psychiatric diseases which prevents communication
- Operations longer than 3 hours
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Study Group
After endotracheal intubation, patients will be positioned in lateral decubitus position.
A linear ultrasound probe will be placed at the edge of scapula at the level of T5-T6.
Under sterile conditions, the landmark points (rhomboid major muscle, 5th and 6th ribs, and intercostal muscles) will be observed and a block needle will be directed to the interfacial plane between rhomboid major muscle and intercostal muscle.
RIB will be performed by injecting 30 ml of bupivacaine 0.25%.
|
After endotracheal intubation, patients will be positioned in lateral decubitus position.
A RIB will be performed at the level of T5-T6 by ultrasound guidance.
A single shot block will be performed by injecting 30 ml of 0.25% bupivacaine to the interfacial plane between rhomboid major muscle and intercostal muscle.
|
No Intervention: Control Group
No block procedure will be performed in this group.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
3rd month chronic pain
Time Frame: At the postoperative 3. month
|
The presence of chronic pain will be evaluated by using the 5. question of Brief Pain Inventory Short Form at the postoperative 3rd month.
The question ranges from 0 (which means no pain) to 10 points (which means worst pain).
The score equal to or over 4 points indicates the presence of chronic pain.
Primary outcome of the study is the difference in the incidence of chronic pain between study and control groups at the postoperative 3rd month.
|
At the postoperative 3. month
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
6th month chronic pain
Time Frame: At the postoperative 6. month
|
The presence of chronic pain will be evaluated by using the 5. question of Brief Pain Inventory Short Form at the postoperative 6th month.
The question ranges from 0 (which means no pain) to 10 points (which means worst pain).
The score equal to or over 4 points indicates the presence of chronic pain.
Secondary outcome of the study is the difference in the incidence of chronic pain between study and control groups at the postoperative 6th month.
|
At the postoperative 6. month
|
3rd month total Brief Pain Inventory Short Form Score
Time Frame: At the postoperative 3. month
|
Total score of Brief Pain Inventory Short Form of all patients will be recorded at the postoperative 3rd month.
The form ranges from 0 point (best score) to 120 (worst score) points.
The 3rd outcome of the study is the difference in total Brief Pain Inventory Short Form scores of patients in the study and control groups at the postoperative 3rd month.
|
At the postoperative 3. month
|
6th month total Brief Pain Inventory Short Form Score
Time Frame: At the postoperative 6. month
|
Total score of Brief Pain Inventory Short Form of all patients will be recorded at the postoperative 6th month.
The form ranges from 0 point (best score) to 120 (worst score) points.
The 3rd outcome of the study is the difference in total Brief Pain Inventory Short Form scores of patients in the study and control groups at the postoperative 6th month.
|
At the postoperative 6. month
|
3rd month neuropathic pain
Time Frame: At the postoperative 3. month
|
The presence of neuropathic pain which will be evaluated by using Douleur Neuropathique 4 (DN4) which ranges from 0 point (no pain) to 10 points (worst pain).
Score equal to or over 4 points indicates the presence of neuropathic pain.
The 5th outcome of the study is the difference in the incidence of neuropathic pain between the study and control groups.
|
At the postoperative 3. month
|
6th month neuropathic pain
Time Frame: At the postoperative 6. month
|
The presence of neuropathic pain which will be evaluated by using Douleur Neuropathique 4 (DN4) which ranges from 0 point (no pain) to 10 points (worst pain).
Score equal to or over 4 points indicates the presence of neuropathic pain.
The 6th outcome of the study is the difference in the incidence of neuropathic pain between the study and control groups at the postoperative 6th month.
|
At the postoperative 6. month
|
acute pain
Time Frame: Postoperative 15. minute, 30. minute, 1.hour, 2nd hour, 6th hour, 12th hour, 24th hour
|
Postoperative acute pain of the patients will be evaluated by using Numerical Rating Scale which ranges between 0 point (no pain) and 10 points (worst pain).
The 7th outcome of the study is the difference in numerical rating scale scores between study and control groups.
|
Postoperative 15. minute, 30. minute, 1.hour, 2nd hour, 6th hour, 12th hour, 24th hour
|
opioid consumption
Time Frame: Postoperative 24th hour.
|
Total opioid consumption of the patients will be recorded at the postoperative 24.
hour.
|
Postoperative 24th hour.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Chair: BAKİYE UĞUR, Muğla Sıtkı Koçman University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
September 7, 2023
Primary Completion (Estimated)
August 1, 2024
Study Completion (Estimated)
January 1, 2025
Study Registration Dates
First Submitted
August 17, 2023
First Submitted That Met QC Criteria
August 24, 2023
First Posted (Actual)
August 31, 2023
Study Record Updates
Last Update Posted (Actual)
October 2, 2023
Last Update Submitted That Met QC Criteria
September 28, 2023
Last Verified
September 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 230022
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
IPD Plan Description
IPD will not be shared with anyone
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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