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This study compare the "Serratus block plane" (SPB) and the local infiltration of the tissue in the prevention of acute and chronic pain after breast cancer surgery.
Chronic pain after breast surgery may be severe, often requiring the use of morphine. The incidence of chronic pain varies from 27 to 50% depending on definitions.
The infiltration of tissues by a local anesthetic is a simple, fast and low risk technique but of limited effectiveness.
Serratus the flat block, performed under ultrasound guidance, is minimally invasive and easy to perform. It allows anesthesia and analgesia to an extended part of the anterolateral chest wall and the axilla. This regional anesthesia technique provides good analgesia during and after breast surgery, but remains to be evaluated; beyond perioperative analgesia, the benefit-risk, post operative rehabilitation, and the impact on ambulatory and on chronic pain are fundamental objectives.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SPB | Experimental | Serratus Plane Bloc with Ropivacaine 2mg/ml (0,3ml/kg) and tissue infiltration with placebo made once, by the anesthetist in the operating theater before surgical incision |
|
| tissue infiltration | Active Comparator | tissue infiltration with Ropivacaine 2mg/ml (0,3ml/kg) and Serratus Plane Bloc with placebo made once, by the anesthetist in the operating theater before surgical incision |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| serratus plane bloc : Ropivacaine 2mg/ml (0,3ml/kg) | Procedure |
| ||
| tissue infiltration : Ropivacaine 2mg/ml (0,3ml/kg) |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative chronic pain assessed using the DN4 questionnaire | DN4 questionnaire | 3 months postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative acute pain | Visual analogue scale (V.A.S.) | day 1, day 2, day 3 postoperative |
| morphine consumption | day 1, day 2, day 3 postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| length of stay in the Postoperative Acute Care Unit | through study completion | |
| length of stay in hospital | through study completion |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Céline Boudart, MD | Contact | 3225553919 | cboudart@ulb.ac.be | |
| Wendy Villareal Fernandez, MD | Contact |
| Name | Affiliation | Role |
|---|---|---|
| Luc Van Obbergh, MD PhD | Erasme University Hospital | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23923989 | Background | Blanco R, Parras T, McDonnell JG, Prats-Galino A. Serratus plane block: a novel ultrasound-guided thoracic wall nerve block. Anaesthesia. 2013 Nov;68(11):1107-13. doi: 10.1111/anae.12344. Epub 2013 Aug 7. | |
| 23811426 | Background | Andreae MH, Andreae DA. Regional anaesthesia to prevent chronic pain after surgery: a Cochrane systematic review and meta-analysis. Br J Anaesth. 2013 Nov;111(5):711-20. doi: 10.1093/bja/aet213. Epub 2013 Jun 28. |
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| Procedure |
|
| serratus plane bloc : placebo | Procedure |
|
| tissue infiltration : placebo | Procedure |
|
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D059350 | Chronic Pain |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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