Serratus Plane Versus Paravertebral Nerve Blocks for Breast Surgery

• Status: Completed
• Trial end date: 2021-02-13
• Target enrollment: 0
• Participant gender: All

Summary

Following painful surgical procedures of the breast, postoperative analgesia is often provided with a paravertebral nerve block (PVB). For intense, but shorter-duration acute pain, a single-injection of local anesthetic is used with a duration of approximately 12 hours. Recently an alternative block has been reported: the serratus plane block.2 The theoretical benefits include ease of administration since it is a plane superficial to the PVB and therefore easier to identify and target with ultrasound (therefore increasing success rate); and an increased safety margin as there are fewer anatomic structures in the immediate area which could be injured with the needle; and, the target plane is much further from the intrathecal/epidural space relative to the PVB, therefore leakage of cerebrospinal fluid or injury to the spinal cord are less likely with the serratus compared to the PVB.3 There are, therefore, multiple theoretical reasons to prefer the serratus over the PVB. Unfortunately, it remains unknown if the analgesia provided by this new technique is comparable to that provided with the PVB.4 The investigators therefore propose to compare these two techniques with a randomized, subject-masked, active-controlled, parallel-arm clinical trial.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of California, San Diego

Criteria

Inclusion Criteria:

• undergoing unilateral or bilateral breast surgery with at least moderate postoperative pain anticipated

• analgesic plan includes a single-injection peripheral nerve block(s)

• age 18 years or older

Exclusion Criteria:

• morbid obesity as defined by a body mass index > 40 (BMI=weight in kg / [height in meters]2)

• renal insufficiency (preoperative creatinine > 1.5 mg/dL)

• chronic opioid use (daily use within the 2 weeks prior to surgery and duration of use > 4 weeks)

• history of opioid abuse

• any comorbidity which results in moderate or severe functional limitation inability to communicate with the investigators or hospital staff

• pregnancy

• planned regional analgesic with perineural catheter placement

• incarceration