"Help us with research that we hope will lead to improved nerve blocks and increased patient satisfaction with their operative experience!"
18 to 100 years old
post- operative pain
Peripheral nerve blocks decrease post-operative pain and therefore narcotic use. While their benefits are clear, little is known about the optimal way to place these blocks – whether it should be done in the operating room, or in the pre-operative area with ultrasound. We are doing this study to examine whether the method of block placement and pain medicine infusion through On-Q catheters impacts efficacy of the block, efficiency of surgery, and patient satisfaction. We hope that this research will lead to improved nerve blocks and increased patient satisfaction with their operative experience
This study requires
If you consent to be enrolled in this research trial, you may be placed into one of two (2) research groups. The two groups are: 1. Pectoralis nerve block placed by anesthesia before surgery 2. Pectoralis nerve block catheter placement intra-operatively by the surgical team. treatment arm.
The treatment you get will be chosen by chance, like flipping a coin. Neither you nor the study doctor will choose what treatment you get. You will be told your treatment group after you sign consent.
If you are randomized to receive a pre-operative block group: The block will be placed before surgery, but after you are under general anesthesia by the anesthesia team, using ultrasound guidance. For the block, an anesthesiologist inject an anesthetic (numbing) medication in the vicinity of the sensory nerves that provide sensation to parts of your chest. The rest of your care will be entirely routine. You will have a normal amount of pain medication after surgery available to you to take as you need.
If you are randomized to the catheter group: During your surgery, your surgeon will place a catheter underneath your pectoralis muscle, near the tissue expander. Pain medicine will infuse slowly over the first four days after your surgery in the vicinity of the sensory nerves that provide sensation to parts of your chest. These catheters will be removed at your first post-operative appointment. The rest of your care will be entirely routine. You will have a normal amount of pain medication after surgery available to you to take as you need.
For all groups, you will complete a short survey that will be emailed to you now and at hours 6 after your surgery. This survey will be emailed to you again at hours 12, 27 and at post-operative day 1-7. An additional 10 question satisfaction survey will be emailed to you one week after surgery. This survey will ask you about the success of your nerve block (if you had one) and your satisfaction with your pain management experience.
Who can participate?
- presenting for breast reconstruction w/ planned two-stage, sub muscular tissue expander placement.
- pregnant, prisoners, cannot consent, history of chronic pain or pain medication use