Comparison of The Effects Of General Anesthesia and PECS Block Methods on Blood Counts in Patients With Breast Cancer

NCT06151639 | Completed

• 1 other identifier: 2023-03/130
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Regional anesthesia and local anesthetics have proven anti-inflammatory and antitumor effects as well as their analgesic properties. On this trial, the investigators are searching anesthetic techniques affect on the leukocyte, platelet-lymphocyte count and ratios, total amount of opioids used, and discharge times in patients who will undergo wire localized lumpectomy operation.

Conditions

Breast Cancer

Keywords

General Anesthesia; PECS block; Neutrophil-Lymphocyte ratio; Platelet-Lymphocyte ratio

Outcome Measures

Primary Outcomes (3)

• lymphocyte values

  difference in preoperative and postoperative lymphocyte values between the general anesthesia and PECS block groups

  postoperative first day

• neutrophil values

  difference in preoperative and postoperative neutrophil values between the general anesthesia and PECS block groups

  postoperative first day

• platelet values

  difference in preoperative and postoperative platelet values between the general anesthesia and PECS block groups

  postoperative first day

Secondary Outcomes (3)

• postoperative Neutrophil/Lymphocyte values

  postoperative first day

• postoperative platelet/lymphocyte ratios

  postoperative first day

• The discharge time

  postoperative first day

Other Outcomes (1)

• total opioid consumption

  intraoperative

Study Arms (2)

Surgery under general anesthesia

13 patients were anesthetized intravenous with routine general anesthesia.

Procedure: general anesthesia

Surgery with Pecs block

13 patients underwent surgery with PECS block

Procedure: peripheral nerve blocks

Interventions

general anesthesia PROCEDURE

General anesthesia was performed by muscle relaxant(rocuronium 0,6 mg/kg), opioids(phentanyl 1-2 mcg/kg) and propofol 2mg/kg. Inhation anesthetics and remiphentanyl infusion were used for maintance general anesthesia.

Surgery under general anesthesia

peripheral nerve blocks PROCEDURE

With the help of ultrasonography, at the 2nd rib level, between the fasciae of the pectoralis major and minor muscles at the mid-clavicle level (PECS I block, interpectoral fascial plane block) and at the 4th rib level, at the mid-axillary level, between the fasciae of the pectoralis minor and serratus muscles (PECS II block, pectoroseratal fascial plane block) local anesthesia was applied. In patients who underwent PECS block, a high-frequency linear ultrasonography (Esaote, My LabFive-Genova, Italy) probe and a 50 mm tip insulated needle (echoplex+, Vygon Ecouen-France) were used. 0.200% bupivacaine 15 ml was applied for the PECS I block, and 0.200% bupivacaine 20 ml was applied for the PECS II block, and fascial separation was observed. Sensory control was performed in the breast and axilla area and the patients were taken into surgery.

Surgery with Pecs block

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study was planned retrospectively. 50 patients who underwent wire localized lumpectomy for breast cancer treatment and diagnosis under general anesthesia (n=25) or PECS block (n=25) were found in hospital records.

You may qualify if:

• Diagnosed with unilateral primary breast cancer
• Are decided to undergo wire localized lumpectomy
• Having a risk score of The American Society of Anaesthesiologists (ASA) risk score 1,2 and 3
• Should be over18 years old

You may not qualify if:

• Being allergic to the anesthetics
• Opioid or steroid usage before the operation
• Patients who could not reach a sufficient block level and required additional doses of analgesics

Sponsors & Collaborators

• Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital: lead

Study Sites (1)

Dr.Abdurrahman Yurtaslan Ankara Oncology Train and Research Hospita

Ankara, Yenimahalle, 06200, Turkey (Türkiye)

Location

Related Publications (8)

• Montejano J, Jevtovic-Todorovic V. Anesthesia and Cancer, Friend or Foe? A Narrative Review. Front Oncol. 2021 Dec 23;11:803266. doi: 10.3389/fonc.2021.803266. eCollection 2021.

  PMID: 35004329 BACKGROUND

• Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002 Dec 19-26;420(6917):860-7. doi: 10.1038/nature01322.

  PMID: 12490959 BACKGROUND

• Weingart SN, Nelson J, Koethe B, Yaghi O, Dunning S, Feldman A, Kent D, Lipitz-Snyderman A. Association between cancer-specific adverse event triggers and mortality: A validation study. Cancer Med. 2020 Jun;9(12):4447-4459. doi: 10.1002/cam4.3033. Epub 2020 Apr 13.

  PMID: 32285614 BACKGROUND

• Forget P, Aguirre JA, Bencic I, Borgeat A, Cama A, Condron C, Eintrei C, Eroles P, Gupta A, Hales TG, Ionescu D, Johnson M, Kabata P, Kirac I, Ma D, Mokini Z, Guerrero Orriach JL, Retsky M, Sandrucci S, Siekmann W, Stefancic L, Votta-Vellis G, Connolly C, Buggy D. How Anesthetic, Analgesic and Other Non-Surgical Techniques During Cancer Surgery Might Affect Postoperative Oncologic Outcomes: A Summary of Current State of Evidence. Cancers (Basel). 2019 Apr 28;11(5):592. doi: 10.3390/cancers11050592.

  PMID: 31035321 BACKGROUND

• Deng F, Ouyang M, Wang X, Yao X, Chen Y, Tao T, Sun X, Xu L, Tang J, Zhao L. Differential role of intravenous anesthetics in colorectal cancer progression: implications for clinical application. Oncotarget. 2016 Nov 22;7(47):77087-77095. doi: 10.18632/oncotarget.12800.

  PMID: 27780923 BACKGROUND

• Gabriel RA, Swisher MW, Sztain JF, Furnish TJ, Ilfeld BM, Said ET. State of the art opioid-sparing strategies for post-operative pain in adult surgical patients. Expert Opin Pharmacother. 2019 Jun;20(8):949-961. doi: 10.1080/14656566.2019.1583743. Epub 2019 Feb 27.

  PMID: 30810425 BACKGROUND

• Bugada D, Lorini LF, Lavand'homme P. Opioid free anesthesia: evidence for short and long-term outcome. Minerva Anestesiol. 2021 Feb;87(2):230-237. doi: 10.23736/S0375-9393.20.14515-2. Epub 2020 Aug 4.

  PMID: 32755088 BACKGROUND

• Chong PH, Yeo ZZ. Parenteral Lidocaine for Complex Cancer Pain in the Home or Inpatient Hospice Setting: A Review and Synthesis of the Evidence. J Palliat Med. 2021 Aug;24(8):1154-1160. doi: 10.1089/jpm.2020.0622. Epub 2020 Dec 22.

  PMID: 33351710 BACKGROUND

MeSH Terms

Conditions

Breast Neoplasms

Interventions

Anesthesia, General

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Anesthesia; Anesthesia and Analgesia

Study Officials

• Guldeniz ARGUN

  Dr. Abdurrahman Yurtaslan Oncology Train and Research Hospita

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor Dr.

Study Record Dates

• First Submitted: November 16, 2023
• First Posted: November 30, 2023
• Study Start: August 1, 2022
• Primary Completion: January 10, 2025
• Study Completion: March 3, 2025
• Last Updated: September 4, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)