Mid-point Transverse Process to Pleura Block for Breast Cancer Surgery: A Randomized Controlled Trial

Analgesic Benefits of the Novel Mid-point Transverse Process to Pleura (MTP) Block for Ambulatory Breast Cancer Surgery: A Randomized Controlled Trial

This study will compare the analgesic effects of midpoint transverse process to pleura (MTP) block to control as well as thoracic paravertebral block.

Paravertebral blocks (PVBs) are frequently used for regional anesthesia for breast surgery. Ultrasound-guided paravertebral block is an advanced skill. The needle tip can be difficult to visualize with ultrasound, and the proximity to neurovascular structures as well as the pleura presents a risk of neurovascular injection and pneumothorax respectively. The midpoint transverse-process to pleura (MTP) block incorporates a novel needle endpoint that is technically easier to achieve and more distant from neurovascular structures and the pleura compared to traditional PVB. This study will compare the analgesic effects of MTP block to control and PVB.

Inclusion Criteria:

• English or French Speaking
• Scheduled for major breast surgery
• ASA physical status classification I-III
• BMI <30kg/m2

Exclusion Criteria:

• Prior ipsilateral breast surgery
• Pre-existing neurological deficit or peripheral neuropathy involving the ipsilateral chest
• Contraindications to regional anesthesia
• Patient refusal of regional technique
• Chronic pain disorder
• Chronic opioid use
• Inability to provide informed consent