New clinical trial aims to optimize pain management and reduce opioid use after mastectomy

MSN highlighted a new University of Cincinnati Cancer Center clinical trial aimed to optimize pain management and reduce the need for opioids after mastectomy procedures. 

Alicia Heelan, MD, and Bradley Budde, MD, are leading the trial, funded by a $50,000 pilot grant supported by contributions from Ride Cincinnati through the Cancer Center Pilot Project Award Program.

Patients undergoing a mastectomy often receive a pectoralis nerve block (PECS block), a pain management tool containing either bupivacaine or Exparel (liposomal bupivacaine) — both of which are approved by the Food and Drug Administration to be used for mastectomy pain management. 

PECS blocks can either be administered by anesthesiologists before surgery under ultrasound guidance or by the surgeon after the mastectomy while the patient is still asleep. While both drugs and both ways to administer the PECS blocks are standards of care, no study has examined the optimal combination that is best at managing pain for patients.

The trial will enroll approximately 100 patients who will be randomized to either bupivacaine or Exparel, administered either before or during surgery. Patients will also be given non-opioid analgesic medications such as acetaminophen or ibuprofen before and after surgery to help manage their pain. 

“The idea is how can we add different things to this so that we don’t need to use opioids exclusively, which is the way things were 10, 20 years ago in health care,” said Budde, a Cancer Center physician researcher and associate professor in the Department of Anesthesiology in UC’s College of Medicine. “If we can minimize the amount of opioids they use, patients will ultimately do better. I think this is a really cool approach to see if timing matters and if the medication used matters.”

“I do emphasize with patients that these are all standards of care and we’re still going to treat their pain. It doesn’t mean that if they’re enrolled in the study that we’re not going to give them pain medications,” said Heelan, a Cancer Center physician researcher, vice chair for quality and assistant professor in the Department of Surgery in UC’s College of Medicine. “We’re trying to take away some of the pain as much as we can when it’s already a tough process.” 

Read the MSN article.

Spectrum News and HemOnc Today also covered this research.

Watch or read the Spectrum News article.

Read the HemOnc Today article.

Featured photo at top of pink Breast Cancer Awareness ribbon. Photo/Lludmila Chernetska/iStock.