BRILMA Block in Breast-Conserving Surgery

Istanbul University

Status: Completed

Conditions: Postoperative Pain

Treatments: Other: Standard intravenous analgesia.; Procedure: BRILMA block

Study type: Interventional

Funder types: Other

Identifiers

NCT07056413

2023/676

Details and patient eligibility

About

Regional analgesia technique in addition to multimodal analgesia in breast-conserving surgery aims to reduce opioid consumption. This study evaluates the postoperative analgesic efficacy of ultrasound-guided BRILMA block in patients undergoing breast conserving surgery.

Full description

Breast-conserving surgery has become a standard surgical approach in the management of early-stage breast malignancies. Despite being less invasive than other oncologic procedures, postoperative pain remains a significant concern. In postoperative pain management, the addition of regional analgesia techniques to multimodal approaches aims to reduce opioid consumption.

First described in 2013, the Serratus-Intercostal Interfascial Plane block targets the branches of the intercostal nerves at the level of the mid-axillary line, specifically around the fourth rib-an anatomical region referred to by the acronym BRILMA. This regional anesthesia technique has demonstrated efficacy in managing postoperative pain, particularly after breast surgery.

In the study, investigators planned to evaluate the postoperative analgesic efficacy of ultrasound-guided BRILMA block via 24-hour morphine consumption in patients undergoing breast conserving surgery.

Enrollment: 60 patients

Sex: Female

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Breast-conserving surgery
• ASA I-III

Exclusion criteria

• Patient refusal
• Presence of contraindications for regional anesthesia ( bleeding disorder, infection at the injection site, local anesthetic allergy)
• Chronic analgesic use
• Preoperative breast pain
• BMI >35

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

Group B: BRILMA block

Experimental group

Description:

20 ml 0.25 % bupivacaine was injected into the fascial plane between the serratus anterior muscle and the external intercostal muscle at T4 level.

Treatment:

Procedure: BRILMA block

Group C: Control

Other group

Description:

Standard intravenous analgesia.

Treatment:

Other: Standard intravenous analgesia.