Nerve block versus non-targeted local anaesthesia in breast surgery.
Research type
Research Study
Full title
A prospective, randomised double-blinded study comparing pectoral nerve block with non-targeted local anaesthetic in bilateral breast surgery.
IRAS ID
170504
Contact name
Anne Dancey
Contact email
Sponsor organisation
BMI Healthcare
Clinicaltrials.gov Identifier
Duration of Study in the UK
0 years, 6 months, 1 days
Research summary
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 squirt 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 in Birmingham. 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, we will specifically ask which breast is the most painful at each time point.
The results of the study may improve patient care.REC name
West Midlands - Black Country Research Ethics Committee
REC reference
15/WM/0205
Date of REC Opinion
14 Aug 2015
REC opinion
Further Information Favourable Opinion