ESPBs vs TAPs for Pain Relief After Breast Reconstruction Surgery
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Female
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Kansas Medical Center
Must not be taking: Opioids
Disqualifiers: Chronic opioid use, others
No Placebo Group
Trial Summary
What is the purpose of this trial?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 bupivacaine 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
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. However, if you are using opioids regularly, you may not be eligible to participate.
What data supports the effectiveness of this treatment for pain relief after breast reconstruction surgery?
Research shows that both the erector spinae plane (ESP) block and the transversus abdominis plane (TAP) block are effective in reducing pain after various surgeries, including abdominal and breast surgeries. The ESP block, in particular, has been successfully used for pain control in breast surgery, which suggests it could be effective for breast reconstruction surgery as well.
12345Are ESPB and TAP blocks safe for humans?
Both Erector Spinae Plane (ESP) blocks and Transversus Abdominis Plane (TAP) blocks are considered safe for humans and have been used effectively for pain relief after various surgeries, including cesarean sections and abdominal surgeries.
12345How does the ESPB treatment differ from other treatments for pain relief after breast reconstruction surgery?
The erector spinae plane block (ESPB) is a newer regional anesthesia technique that is simpler and potentially safer than other methods like the paravertebral block, and it provides effective pain relief by targeting nerves in the back. This makes it unique compared to traditional pain relief methods, which may not offer the same ease of administration or safety profile.
12356Eligibility Criteria
This trial is for adult women with breast cancer, who are in good to moderate health (ASA 1-3), and are scheduled for DIEP flap surgery. It's not open to those who regularly use opioids, have allergies to local anesthetics, or can't describe their pain level using a number scale.Inclusion Criteria
I am a woman with breast cancer, in good to moderate health, getting DIEP flap surgery.
Exclusion Criteria
I cannot use certain pain medications due to chronic opioid use or allergies.
You are unable to tell how much pain you are feeling using a number scale.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive either Erector Spinae Plane blocks or Transversus Abdominis Plane blocks for post-operative analgesia following DIEP flap surgery
Immediate post-operative period
1 visit (in-person)
Follow-up
Participants are monitored for pain control and opioid requirements post-surgery
6 months
Multiple visits (in-person and virtual)
Participant Groups
The study compares two types of pre-operative pain blocks: Erector Spinae Plane blocks (ESPBs) and Transversus Abdominus Plane blocks (TAPs). The goal is to see if ESPBs provide similar pain relief after breast reconstruction surgery as the commonly used TAPs do.
2Treatment groups
Experimental Treatment
Group I: Group 2: Transversus Abdominis Plane blocksExperimental Treatment1 Intervention
Transversus Abdominis Plane blocks
Group II: Group 1: Erector Spinae Plane blocksExperimental Treatment1 Intervention
Erector Spinae Plane blocks
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of Kansas Medical CenterKansas City, KS
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Who Is Running the Clinical Trial?
University of Kansas Medical CenterLead Sponsor
References
Erector Spinae Plane Block versus Transversus Abdominis Plane Block for Postoperative Analgesia in Abdominal Surgery: A Systematic Review and Meta-Analysis. [2022]Regional anesthesia technique has been reported to exert excellent analgesic efficacy for various surgeries. Erector spinae plane block (ESPB) and transversus abdominis plane (TAP) block are good ways to relieve postoperative pain after abdominal surgery. However, the analgesic efficacy between them remains controversial. This meta-analysis evaluated the analgesic effect between these two blocks in abdominal surgery with statistical and clinical interpretation.
Comparison between erector spinae plane block and paravertebral block regarding postoperative analgesic consumption following breast surgery: a randomized controlled study. [2022]Pain control following breast surgery is of utmost importance in order to reduce the chance of chronic pain development, and facilitate early rehabilitation. The erector spinae plane block (ESPB) is a recently developed regional anaesthesia procedure successfully used for different types of surgical procedures including thoracic and abdominal surgeries.
Randomized Comparative Study Between Bilateral Erector Spinae Plane Block and Transversus Abdominis Plane Block Under Ultrasound Guidance for Postoperative Analgesia After Total Abdominal Hysterectomy. [2022]Ultrasound-guided erector spinae plane (ESP) block has emerged as an effective and safe analgesic regional technique and it also provides visceral pain relief. Our aim was to compare the analgesic efficacy of ESP block over transversus abdominis plane (TAP) block under ultrasound guidance following a total abdominal hysterectomy.
Erector spinae plane block and transversus abdominis plane block for postoperative analgesia in cesarean section: A prospective randomized comparative study. [2023]Erector spinae plane (ESP) block is an interfascial plane block given at the paraspinal region and provides effective visceral and somatic analgesia. Transversus abdominis plane (TAP) block is also an interfascial block that provides adequate somatic pain control. We conducted this study to compare the analgesic efficacy of ESP and TAP blocks with ropivacaine for 48 h after the cesarean section.
Bilateral Ultrasound-Guided Erector Spinae Plane Block Versus Transversus Abdominis Plane Block on Postoperative Analgesia after Total Abdominal Hysterectomy. [2020]Transversus abdominis plane (TAP) blocks provide postoperative pain relief after various abdominal surgeries. Recently, erector spinae plane (ESP) block has obtained vast attention due to its simplicity and usage in truncal procedures.
Paravertebral block versus erector spinae plane block for analgesia in modified radical mastectomy: a randomized, prospective, double-blind study. [2023]Pain control after breast surgery is crucial and supported with regional techniques. Paravertebral block (TPVB) is shown to be effective in postoperative pain management. Erector spinae plane block (ESPB) is assumed to have a similar analgesic effect as an easier and safer block. Our aim was to compare TPVB and ESPB for modified radical mastectomy (MRM) in terms of analgesic efficiency and dermatomal spread.