Nerve Blocks in Alloplastic Breast Reconstruction

Summary

Pain management is a major concern in oncologic breast surgery and reconstruction. Significant risks for acute and chronic pain after surgery might be reduced through improved pain control pre-operatively. Addition of regional anesthesia to a multimodal peri-operative pain management protocol offers a promising solution for improved recovery. For patients undergoing mastectomy with immediate alloplastic breast reconstruction, this RCT compares TPVB+Pecs local anesthetic block with TPVB local anesthetic block and Pecs placebo normal saline block for their effect on acute pain, chronic pain, opioid consumption, opioid-related side effects, patient-reported quality of recovery after surgery, and length of stay.

Timeline

Start

2021-05-01

Primary completion

2024-05

Completion

2024-08

Publications

• Wells H, Malik K, Brasher PMA, Bovill E, Van Laeken N, Warburton R, Prabhakar C, Li XL, Isaac KV. The addition of interpectoral and pectoserratus fascial plane blocks to paravertebral blocks for analgesia after total mastectomy and immediate breast reconstruction: a pilot feasibility randomized controlled trial. Can J Anaesth. 2025 Sep;72(9):1387-1396. doi: 10.1007/s12630-025-03030-1. Epub 2025 Sep 22.

Drugs

Indications