Comparing Liposomal Bupivacaine and Bupivacaine with Dexmedetomidine for Pain Relief After Mastectomy in Cancer Patients

What this Trial Is About

Researchers are comparing how long pain relief lasts between two types of local anesthetic combinations used during erector spinae plane blocks for patients undergoing mastectomy surgery for breast cancer. This trial aims to see if adding dexmedetomidine to bupivacaine provides longer or more effective pain control than using liposomal bupivacaine with bupivacaine alone. The study measures differences in pain relief duration and the amount of opioid pain medication needed after surgery. Participants will receive an erector spinae plane block guided by ultrasound performed by the Acute Pain Service team. Patients are randomly assigned by month to receive either bupivacaine 0.25% with liposomal bupivacaine or bupivacaine 0.25% with dexmedetomidine. The local anesthetic is delivered using a needle placed under direct visualization into the erector spinae plane, with doses adjusted by patient weight and surgical side. All patients receive 10 mg intravenous dexamethasone after anesthesia induction. During the hospital stay, pain scores and opioid use in morphine equivalents are recorded every 6 hours starting in the recovery area until discharge. After discharge, participants are contacted at 72 hours to report daily pain scores and opioid tablet use since leaving the hospital. The primary outcome is the density and duration of pain relief over 96 hours, while secondary measures include total oral opioid consumption during the same period.

Liposomal Bupivacaine Vs Bupivacaine with Dexmedetomidine in Erector Spinae Plane Blocks for Mastectomies