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Postoperative Pain Following Modified Radical Mastectomy for Breast CancerNCT06548646

Ultrasound-guided Thoracic Interfascial Plane Nerve Block Versus Erector Spinae Plane Block for Pain Control After Modified Radical Mastectomy

A study testing Thoracic Interfascial Plane Block and Erector Spinae Plane Block in people with Postoperative Pain Following Modified Radical Mastectomy for Breast Cancer, run by Safie ramez tewfeik abd el moneim at 1 site in Egypt.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study compares two methods of local pain control in patients undergoing Modified Radical Mastectomy, a common surgery for breast cancer( tumor in the breast) treatment. It aims to determine which method, the Thoracic Interfascial Plane Block or the Erector Spinae Plane Block, provides better pain relief after… Read more about this study

Who is it for?
Ages 21 years and older, women only
What is being tested?
Thoracic Interfascial Plane Block and Erector Spinae Plane Block
Could I receive a placebo?
No, everyone receives an active treatment
How many people
200 participants
Where
1 siteEgypt
Study dates
1 Nov 2024to 20 Jun 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Female patients older than 21 years old
  • American Society of Anesthesiologists (ASA) physical status II.

Who cannot join

  • Known allergy to one of the study medications.
  • Skin infections at the site of the needle puncture.
  • Significant organ dysfunction (hepatic, renal, or cardiac dysfunction), coagulopathy or recent anticoagulant use, epilepsy.
  • Patients diagnosed with obstructive sleep apnoea, pulmonary compromise .

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • Ainshams University Hospitals

    Cairo, Abbasiya, 1181

Other trials in Egypt

About this study

Official title: Ultrasound-guided Thoracic Interfascial Plane Nerve Block Versus Erector Spinae Plane Block for Postoperative Pain Control in Patients Undergoing Modified Radical Mastectomy

This study compares two methods of local pain control in patients undergoing Modified Radical Mastectomy, a common surgery for breast cancer( tumor in the breast) treatment. It aims to determine which method, the Thoracic Interfascial Plane Block or the Erector Spinae Plane Block, provides better pain relief after surgery, reduces side effects,decrease the incidence of persistent pain,improve quality of life and increases patient satisfaction.

Why This Study Is Important:

Read more

Breast cancer surgery can cause significant pain, and managing this pain is important for a quick recovery. Currently, pain is often managed with opioids, which can cause side effects like nausea and drowsiness. investigators want to find a method that controls pain effectively with fewer side effects, helping patients recover faster and feel better.

Who Can Take Part:

Women aged 21 and older who are scheduled for a Modified Radical Mastectomy at Ain Shams University hospitals can participate in this study.

What Will Happen During the Study:

Participants will be randomly assigned to receive either the Thoracic Interfascial Plane Block or the Erector Spinae Plane Block before surgery.

Pain levels will be measured using a numerical pain score from 1 to 10. Researchers will track the amount of pain medication needed, the time it takes to feel pain relief, and any side effects.

Other factors such as time to start walking again, and overall satisfaction with pain control will also be recorded.long term outcomes such as Persistent pain, Brief Pain Inventory interference, DN4-interview score, analgesic use and quality of life at 3 and 6 months.

What investigators hope to Learn:

Investigators hope to find out which nerve block provides better pain relief after surgery. By comparing TIPB and ESPB, with the aim to identify the method that:

Requires less additional pain medication Has fewer side effects Improves sleep quality and overall recovery Increases patient satisfaction

Significance:

This study could lead to better pain management strategies for breast cancer surgery, reducing the need for opioids and enhancing patient recovery and comfort, and improving long term satisfaction and quality of life.

Participation:

Participants will be monitored closely during and after the procedure to ensure their safety and well-being. The results of this study could help improve pain management for future patients undergoing similar surgeries.

Read the detailed description

This study is a randomized, double-blinded clinical trial comparing the efficacy of two ultrasound-guided nerve blocks for postoperative pain management in patients undergoing Modified Radical Mastectomy (MRM). The two techniques under investigation are the Thoracic Interfascial Plane Block (TIPB) and the Erector Spinae Plane Block (ESPB). Both nerve blocks are administered to provide targeted pain relief by numbing specific nerves involved in the surgical area.

Methodology:

Participants will be randomly assigned to one of two groups to receive either TIPB or ESPB. The randomization will ensure unbiased distribution of participants across both groups. The nerve blocks will be administered preoperatively under ultrasound guidance to ensure accurate placement and effectiveness.

Assessments and Measurements:

Pain levels will be assessed using the Visual Analog Scale (VAS) at multiple time points postoperatively, including at rest and during movement. The primary outcome measure is the total amount of rescue pain medication required within the first 48 hours after surgery. Secondary outcomes include the time to first rescue analgesic, intraoperative fentanyl consumption, hemodynamic parameters, sleep quality, time to first ambulation, VAS scores for pain and nausea, and overall patient satisfaction. Persistent pain, Brief Pain Inventory interference, DN4-interview score, analgesic use and quality of life will be assessed by blinded interview at 3 and 6 months

Safety and Monitoring:

Participants will be monitored for adverse events, including complications related to the nerve block techniques. Hemodynamic parameters, such as blood pressure and heart rate, will be closely observed during the perioperative period to ensure patient safety.

Significance:

The findings from this study aim to identify a short and long term superior pain management strategy that minimizes opioid consumption, reduces side effects, and enhances recovery and patient satisfaction following MRM. If successful, the results could inform clinical practice and improve postoperative care for breast cancer patients.

This study is conducted at Ain Shams University hospitals and adheres to ethical guidelines to ensure the safety and well-being of all participants.

Being tested
Thoracic Interfascial Plane Block, Erector Spinae Plane Block
Keywords
breast cancer, Modified Radical Mastectomy, Mastectomy, postoperative pain, Erector Spinae Plane Block, Thoracic Interfascial Plane Block
Medical subject headings
Breast Neoplasms, Pain, Postoperative

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Thoracic Interfascial Plane BlockProcedure or surgery

    Also called Thoracic Nerve Block, TIPB

    The Thoracic Interfascial Plane Block (TIPB) is a regional anesthesia technique used to manage postoperative pain, particularly in thoracic and breast surgeries. This block involves the injection of a local anesthetic into the fascial plane between the thoracic muscles, targeting the nerves that supply the chest wall and upper abdominal area. It includes Pecto-Intercostal Fascial Plane Block (PIFB) and Serratus Intercostal Fascial Plane Block (SIFB).

  • Erector Spinae Plane BlockProcedure or surgery

    Also called ESPB

    The Erector Spinae Plane Block (ESPB) is a regional anesthesia technique used to manage pain, particularly in thoracic and abdominal surgeries. This block involves the injection of a local anesthetic into the plane between the erector spinae muscle and the transverse processes of the vertebrae.

Study groups in NCT06548646
Study groupRoleWhat they receive
Thoracic Interfascial Plane BlockExperimentalthe Thoracic Interfascial Plane Block, which includes Pecto-Intercostal Fascial Plane Block and Serratus Intercostal Fascial Plane Block, is a peripheral nerve block that targets the intercostal nerve branches scattered throughout the chest and axilla
Receives: Procedure: Thoracic Interfascial Plane Block
Erector Spinae Plane BlockActive comparatorErector Spinae Plane Block (ESPB) is an anesthesia technique for providing effective analgesia during and after breast and abdominal surgery
Receives: Procedure: Erector Spinae Plane Block

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Total amount of rescue pain medication required within the first 48 hours after surgery

    Researchers will report the total amount of analgesia used in the first 48 hours after surgery

    Measured: 48 hours

Secondary outcomes (12)
  1. Time to first rescue analgesia'

    The time at which the first analgesia is adminstered after surgery

    Measured: 48 hours

  2. Total intraoperative fentanyl consumption

    The total intraoperative consumption of fentanyl

    Measured: Total intraoperative time of surgery

  3. Time for the first ambulation

    The time at which the patient will be first be able to ambulate from bed.

    Measured: 48 hours

  4. VAS score for pain

    The postoperative pain using The Visual Analogue Scale (VAS) from 0 to 10, with two endpoints representing 0 ('no pain') and 10 ('pain as bad as it could be).

    Measured: 48 hours

  5. VAS score for nausea

    nausea during the postoperative period using Visual Analogue Scale (VAS) with two endpoints representing 0 ('no nausea') and 10 ('nausea as bad as it could be')

    Measured: 48 hours

  6. Patient Satisfaction score

    (five-point Likert scale) where (1 = extremely dissatisfied to 5 = extremely satisfied) to measure postoperative patient satisfaction.

    Measured: 48 hours

  7. presence of persistent pain

    pain in the operated breast, chest wall, axilla or ipsilateral arm that had been present since surgery and was not explained by local recurrence, infection or another identifiable cause on a 0-10 numerical rating scale

    Measured: 3 months and 6 months

  8. Pain interference

    The seven interference items of the Brief Pain Inventory (general activity, mood, walking ability, normal work, relations with other people, sleep and enjoyment of life; each scored 0-10) were recorded, and the interference score was calculated as their mean

    Measured: 3 months and 6 months

  9. Neuropathic symptoms

    Douleur Neuropathique 4 questionnaire (DN4-interview; range 0-7), a score of 3 or more indicated neuropathic pain

    Measured: 3 and 6 months

  10. Analgesic use and pain-clinic attendance

    Patients were asked which medicines they were taking for surgical-site pain and at what daily dose and number of visits to pain-management clinic which then confirmed by hospital registry ,clinic and pharmacy records

    Measured: 3 and 6 months

  11. Patient Global Impression of Change

    recorded on a seven-point scale from 1 (very much improved) to 7 (very much worse); scores of 1 or 2 were considered a clinically important improvement.

    Measured: 3 and 6 months

  12. Health-related quality of life

    EORTC QLQ-C30 and its breast cancer module (QLQ-BR23) validated Arabic versions

    Measured: 3 and 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Aug 2024
  2. Study start1 Nov 2024
  3. Primary completion1 Dec 2025
  4. Study completion20 Jun 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
200 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06548646
Sponsor's protocol ID
MD178/2023
Status last verified
Oct 2026
First submitted
4 Aug 2024
Last updated
16 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kaur U, Shamshery C, Agarwal A, Prakash N, Valiveru RC, Mishra P. Evaluation of postoperative pain in patients undergoing modified radical mastectomy with pectoralis or serratus-intercostal fascial plane blocks. Korean J Anesthesiol. 2020 Oct;73(5):425-433. doi: 10.4097/kja.20159. Epub 2020 Sep 24.

    PubMed 32987492
  • Hong B, Yoon SH, Youn AM, Kim BJ, Song S, Yoon Y. Thoracic interfascial nerve block for breast surgery in a pregnant woman: a case report. Korean J Anesthesiol. 2017 Apr;70(2):209-212. doi: 10.4097/kjae.2017.70.2.209. Epub 2017 Jan 12.

    PubMed 28367293
  • Zhang H, Miao Y, Qu Z. Refining a great idea: the consolidation of PECS I, PECS II and serratus blocks into a single thoracic fascial plane block, the SAP block-a concern on the muscle pain. Reg Anesth Pain Med. 2020 Jun;45(6):480. doi: 10.1136/rapm-2019-101042. Epub 2019 Oct 25. No abstract available.

    PubMed 31653798
  • Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.

    PubMed 2748771
  • Boogaerts JG, Vanacker E, Seidel L, Albert A, Bardiau FM. Assessment of postoperative nausea using a visual analogue scale. Acta Anaesthesiol Scand. 2000 Apr;44(4):470-4. doi: 10.1034/j.1399-6576.2000.440420.x.

    PubMed 10757584

Questions about this trial

What is this clinical trial studying?

A study testing Thoracic Interfascial Plane Block and Erector Spinae Plane Block in people with Postoperative Pain Following Modified Radical Mastectomy for Breast Cancer, run by Safie ramez tewfeik abd el moneim at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Total amount of rescue pain medication required within the first 48 hours after surgery (time frame: 48 hours). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06548646, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Oct 2026.

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