Pain, Post Operative Clinical Trial
Official title:
A Prospective, Randomised Double Blinded Study Comparing a Pectoral Nerve Block With Non-targeted Local Anaesthetic in Bilateral Breast Surgery
Effective postoperative pain control is an essential component of surgery. Adequate
analgesia improves patient comfort and satisfaction, thereby permitting earlier
mobilisation, faster recovery and less likelihood of complications.The majority of surgeons
will place 10ml of local anaesthetic into the breast pocket or inject it into the breast
skin following breast surgery. A more specific technique is to identify the nerves supplying
the breast and put the local anaesthetic directly around them (Pec block). This nerve block
has recently been described and is increasingly being used by anaesthetists for surgery
under local anaesthetic or for post-operative analgesia. It has been shown to provide better
and more specific pain relief in several studies.
Anaesthetists use an ultrasound machine to identify the anatomical landmarks for the nerves
and they inject into the vicinity. They do not have direct vision and there is a risk of
causing morbidity or the block not being effective. It is much easier for a surgeon to apply
the block, as they can see the anatomical landmarks. Despite this, very few surgeons are
aware of the technique.
The study group consists of patients undergoing bilateral cosmetic breast surgery at BMI
Edgbaston and Priory hospitals and Spire Parkway and Southbank hospitals in Birmingham and
Worcester. If a patient consents to being involved in the research, they will have one
breast randomised to receiving a pec block and the contralateral (opposite) breast will
receive the same amount of local anaesthetic placed in the breast pocket in a non-targeted
fashion. The patients and researcher will be blinded as to the allocation. Patients will
complete a verbal numeric pain score for each breast at set intervals until they are
discharged.In addition, the investigators will specifically ask which breast is the most
painful at each time point.
The results of the study may improve patient care.
Status | Recruiting |
Enrollment | 50 |
Est. completion date | September 2016 |
Est. primary completion date | September 2016 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Female |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Patient requesting a bilateral breast procedure (reduction, mastopexy or augmentation). - Patient willing to sign the informed consent form agreeing to its items after explanation of the study by the operating surgeon. Exclusion Criteria: - Declining to give written consent. - History of allergy to chirocaine local anaesthetic. - Prior breast surgery. - Chronic pain disorder. - Significant medical co-morbidities. |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United Kingdom | Edgbaston BMI Hospital | Birmingham | West Midlands |
Lead Sponsor | Collaborator |
---|---|
BMI Healthcare |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | targeted question as to which breast is more painful | patient is asked which breast is more painful | 3 hours post-operatively | No |
Secondary | verbal numeric rating scale(VNRS) | standard validated pain score | 3 hours post-operatively | No |
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