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Reducing Pain and Disability After Breast Cancer Surgery

2014-07-24 14:06:50 | BioPortfolio

Summary

The purpose of this study is to determine if the combination of thoracic paravertebral block and multimodal analgesia will decrease chronic pain and arm morbidity in patients undergoing breast cancer surgery with lymph node dissection as compared to patients receiving local anesthesia with multimodal analgesia.

Description

Sixty percent of breast cancer patients undergo some form of breast surgery in the treatment of the early stages of the disease. The recovery from surgery can be associated with severe disabling pain persisting beyond 12 months after surgery. Research in pain has shown that early intervention of acute pain can prevent long term chronic pain.

At The Ottawa Hospital, patients receive either paravertebral blocks or wound infiltration with local anesthetic for postoperative pain management. We would like to compare these two methods of pain control to determine an analgesic technique that will reduce acute and chronic pain, and maximally improve long-term functional recovery and patient's quality of life.

Study Design

Allocation: Randomized, Control: Active Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention

Conditions

Breast Cancer

Intervention

Thoracic Paravertebral Block (TPVB), Local Anesthetic

Location

The Ottawa Hospital
Ottawa
Ontario
Canada
K1Y 4E9

Status

Recruiting

Source

Ottawa Hospital Research Institute

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-07-24T14:06:50-0400

Clinical Trials [6337 Associated Clinical Trials listed on BioPortfolio]

Comparison of Thoracic Paravertebral Block to Serratus Anterior Plane Block in Breast Surgery

The investigators hypothesize that the analgesic efficacy of ultrasound-guided serratus anterior plane block will provide better analgesia with fewer complications in comparison to ultraso...

Comparison of the Clinical Efficacy of 2 Paravertebral Block Strategies in Thoracic Surgery by Thoracotomy: by the Anesthetist (Paravertebral Block Guided by Ultrasound) and by the Thoracic Surgeon (Paravertebral Block Visual)

Post-thoracotomy pain is one of the most severe. The local analgesia allows its effective control and a reduction of postoperative morbidity and mortality. The gold standard for local ana...

Effects of Open Thoracic Paravertebral Block on Postoperative Analgesia

The study was aimed to assess the effects of open thoracic paravertebral block on postoperative analgesia in patients undergoing open pulmonary lobectomy under general anesthesia. Then, A ...

Thoracic Paravertebral Blcok : Effect on Acute Pain and Chronic and Quality of Life After Hepatectomy With Right J-shape Subcostal Incision

This prospective, randomized study,control study aims to compare the analgesic effect,opioids consumption,quality of recovery,length of hospital stay and incidence of chronic pain,et al. b...

Erector Spinae Plane Block Versus Paravertebral Block in Mastectomy

In this randomized, controlled, observer-blinded study the investigators plan to evaluate ultrasound-guided thoracic paravertebral block (TPVB) and ultrasound-guided thoracic erector spina...

PubMed Articles [20729 Associated PubMed Articles listed on BioPortfolio]

Percutaneous Radiofrequency Ablation of Pulmonary Metastasis and Thoracic Paravertebral Block Under Computed Tomographic Scan Guidance: A Case Report.

Pain during and after pulmonary percutaneous radiofrequency ablation (RFA) may be severe enough to require opioids. Thoracic paravertebral block (TPVB) is a regional anesthetic technique that can reli...

Real-time view of anesthetic solution spread during an ultrasound-guided thoracic paravertebral block.

Thoracic paravertebral block is a technique for perioperative analgesia in patients undergoing thoracic, chest wall, or breast surgery, or for pain management with rib fractures, which can be performe...

Spread of Quadratus Lumborum Block to the Paravertebral Space Via Intramuscular Injection: A Volunteer Study.

Several types of quadratus lumborum block (QLB) are used for postoperative analgesia and are believed to be effective against both somatic and visceral pain via a local anesthetic (LA) effect in the p...

Thoracic paravertebral nerve block for treating contraction of the latissimus dorsi muscle after breast cancer surgery.

Adding sufentanil to ropivacaine in continuous thoracic paravertebral block fails to improve analgesia after video-assisted thoracic surgery: A randomised controlled trial.

The benefit of adding opioid to a local anaesthetic for continuous thoracic paravertebral analgesia after video-assisted thoracic surgery (VATS) is unclear.

Medical and Biotech [MESH] Definitions

Interruption of sympathetic pathways, by local injection of an anesthetic agent, at any of four levels: peripheral nerve block, sympathetic ganglion block, extradural block, and subarachnoid block.

A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016).

Abnormal accumulation of lymph in the arm, shoulder and breast area associated with surgical or radiation breast cancer treatments (e.g., MASTECTOMY).

Metastatic breast cancer characterized by EDEMA and ERYTHEMA of the affected breast due to LYMPHATIC METASTASIS and eventual obstruction of LYMPHATIC VESSELS by the cancer cells.

Interruption of the conduction of impulses in peripheral nerves or nerve trunks by the injection of a local anesthetic solution. (Stedman, 26th ed)

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