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NCT06091241NARecruiting

ESPBs vs TAPs for Satisfactory Analgesia Following DIEP Surgery

University of Kansas Medical Center

Start Date

11/1/2023

Completion Date

12/31/2026

Summary

Breast cancer is the second most common cancer diagnosed in American women . For patients who have undergone surgical mastectomy, autologous breast reconstruction is an alternative option to breast implants. Deep Inferior Epigastric Perforator (DIEP) flaps are the gold standard for autologous breast reconstruction . Effective pain control following surgery is imperative and ultrasound-guided bilateral transversus abdominis plane blocks (TAPs) with the infiltration of local anesthetics, such a ropivacaine are a common regional technique of choice . A newer described technique, bilateral Erector Spinae Plane blocks (ESPBs) (which also are an infiltration of local anesthetic) present as an alternative approach for post-operative analgesia. ESPBs have been proven efficacious in reducing intra- and post-operative opioid requirements, lessening the need for rescue analgesics in other similar surgical procedures. The hypothesis is that preoperative bilateral ESPBs could provide equivalent pain control as a regional analgesic for patients undergoing DIEP flap surgery when compared to preoperative bilateral TAPs

Eligibility Criteria

Age Range: 18 years to 70 years

Inclusion Criteria: * Adult women with breast cancer, ASA 1-3, undergoing DIEP flap surgery Exclusion Criteria: * Chronic opioid use contraindications to local anesthetics or regional analgesia Inability to communicate intensity of pain on a numeric analog scale

Interventions

PROCEDURE

Pre-operative Erector Spinae Plane block prior to DIEP surgery

PROCEDURE

Pre-operative Transversus Abdominus Plane blocks prior to DIEP surgery

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Conditions

Pain

Locations

University of Kansas Medical Center

Kansas City, Kansas 66160

United States