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- Essai clinique NCT07659990
RISS Versus SPSIP Block in Modified Radical Mastectomy (RSMRM)
Comparison of Rhomboid Intercostal-Subserratus Plane Block and Serratus Posterior Superior Intercostal Plane Block for Postoperative Analgesia and Dermatomal Spread After Modified Radical Mastectomy: A Randomized Double-Blind Trial
Aperçu de l'étude
Statut
Les conditions
Description détaillée
Breast cancer surgery is frequently associated with moderate to severe postoperative pain, which may negatively affect recovery and increase opioid consumption. Ultrasound-guided fascial plane blocks have become an important component of multimodal analgesia strategies for breast surgery.
The rhomboid intercostal-subserratus plane (RISS) block and serratus posterior superior intercostal plane (SPSIP) block are recently described regional anesthesia techniques that may provide effective postoperative analgesia by blocking the lateral and posterior branches of the thoracic spinal nerves. However, comparative clinical evidence regarding their analgesic efficacy and dermatomal coverage in modified radical mastectomy remains limited.
This prospective randomized double-blind controlled trial will compare RISS block and SPSIP block in adult patients undergoing modified radical mastectomy under general anesthesia. Participants will be randomly allocated to receive either RISS block or SPSIP block before surgery. The primary objective is to compare postoperative opioid consumption. Secondary outcomes include postoperative pain scores, dermatomal sensory spread, time to first rescue analgesia, quality of recovery, opioid-related adverse events, and block-related complications.
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Yusuf Alan, MD
- Numéro de téléphone: +905396210977
- E-mail: dryusufalan@gmail.com
Lieux d'étude
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-
Nilüfer
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Bursa, Nilüfer, Turquie (Türkiye), 16100
- Recrutement
- Bursa City Hospital
-
Contact:
- Yusuf Alan, MD
- Numéro de téléphone: 05396210977
- E-mail: dryusufalan@gmail.com
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Female patients aged 18-75 years
- ASA physical status I-III
- Scheduled for elective unilateral modified radical mastectomy with axillary dissection under general anesthesia
- Provision of written informed consent
Exclusion Criteria:
- Anticoagulant therapy
- Bleeding diathesis
- Known allergy to local anesthetics or opioids
- Infection at the block application site or previous surgery in the block area
- Cognitive impairment preventing NRS assessment
- Pregnancy or lactation
- Chronic opioid use
- Severe hepatic or renal failure
- Refusal to participate in the study
- Technical inability to perform the block or failed block
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Tripler
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: RISS Block
Patients will receive an ultrasound-guided rhomboid intercostal-subserratus plane (RISS) block before modified radical mastectomy for postoperative analgesia.
|
Ultrasound-guided rhomboid intercostal-subserratus plane block performed before modified radical mastectomy for postoperative analgesia.
|
|
Expérimental: SPSIP Block
Patients will receive an ultrasound-guided serratus posterior superior intercostal plane (SPSIP) block before modified radical mastectomy for postoperative analgesia.
|
Ultrasound-guided serratus posterior superior intercostal plane block performed before modified radical mastectomy for postoperative analgesia.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Total Postoperative Opioid Consumption
Délai: 24 hours after surgery
|
Total opioid consumption during the first 24 hours after modified radical mastectomy.
|
24 hours after surgery
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Intraoperative Remifentanil Consumption
Délai: During surgery
|
Total intraoperative remifentanil consumption will be recorded and compared between groups.
|
During surgery
|
|
Postoperative Pain Scores
Délai: 0-24 hours after surgery
|
Postoperative pain intensity measured using the Numeric Rating Scale (NRS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain.
Higher scores indicate worse pain.
|
0-24 hours after surgery
|
|
Compartmental Pain Scores Using Numeric Rating Scale
Délai: 0-24 hours after surgery
|
Numeric Rating Scale (NRS) score (0-10 points) measured separately for axillary pain, anterolateral chest wall pain, and surgical drain insertion site pain.
A score of 0 indicates no pain and 10 indicates the worst imaginable pain.
Higher scores indicate greater pain intensity.
|
0-24 hours after surgery
|
|
Dermatomal Sensory Block Distribution
Délai: 30 minutes after block performance
|
Number of dermatomes blocked, assessed by pinprick sensory testing 30 minutes after block performance.
Higher values indicate wider sensory block distribution.
|
30 minutes after block performance
|
|
Quality of Recovery-15 Score
Délai: 24 hours after surgery
|
Quality of Recovery-15 (QoR-15) questionnaire score ranging from 0 to 150, where higher scores indicate better postoperative recovery and patient satisfaction.
|
24 hours after surgery
|
|
Block- and Opioid-Related Complications
Délai: 24 hours after surgery
|
Complications related to block performance and opioid use will be recorded.
|
24 hours after surgery
|
Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Mürsel Ekinci, MD, Bursa City Hospital
- Chaise d'étude: Yusuf Alan, MD, Bursa City Hospital
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- La douleur
- Manifestations neurologiques
- Complications postopératoires
- Processus pathologiques
- Tumeurs par site
- Tumeurs
- Maladies de la peau
- Maladies du sein
- Conditions pathologiques, signes et symptômes
- Maladies de la peau et du tissu conjonctif
- Signes et symptômes
- Douleur, Postopératoire
- Tumeurs mammaires
Autres numéros d'identification d'étude
- MRM-2025-KAEK47
- 2025-KAEK-47 (Autre identifiant: Clinical Research Ethics Committee of University of Health Sciences Bursa Faculty of Medicine)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
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