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Pectoral Nerve Blocks (PECS) for Postoperative Analgesia after Breast Surgeries: A Randomised Clinical Study

Sowmya Madihalli Janardhan Iyengar , Navyashree Krishnashastry Srinivasa1 , Sowmya Madihalli Janardhan Iyengar2 , Kailash Prakash3 , Hiremathada Sahajananda4 , Maya Dinkar Nadakarni5

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Indian Journal of Anesthesia and Analgesia 6(5):p 1701-1706, September-October 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.30

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Navyashree Krishnashastry Srinivasa, Sowmya Madihalli Janardhan Iyengar, Kailash Prakash et al. Pectoral Nerve Blocks (PECS) for Postoperative Analgesia after Breast Surgeries: A Randomised Clinical Study. Indian J Anesth Analg. 2019;6(5 P-II):1701-1706.

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Abstract

Context: Pectoral nerve blocks (PECS) is a novel technique introduced to provide analgesia for anterior and lateral chest wall surgeries. Aims: The present study was planned to evaluate the efficacy and safety of ultrasound-guided PECS 1 and 2 block for postoperative analgesia after breast surgeries. Settings and Design: Prospective, randomized, placebo controlled clinical study. Methods and Material: Forty female patients of ASA I/II, undergoing breast surgeries were recruited and randomly allocated into two groups. Group P patients were subjected to ultrasound-guided PECS block with 0.375% Inj. Ropivacaine (10 ml at PECS 1 and 20 ml at PECS 2) and Group C patients were injected with 0.9% saline at PECS I and II sites before reversal from anesthesia. Post operatively VAS scores, time of administration of the first rescue analgesic, number of rescue analgesics, level of blockade were recorded and rescue analgesia with Inj. Fentanyl 1 mcg/kg was given when the VAS score was 4 or more. Statistical analysis used: Data collected were tested for normalcy using the Shapiro Wilk test and compared using the Mann Whitney U test, Student T test and Pearson’s chi-square test using the SPSS software version 23. p-values less than 0.05 was considered statistically significant. Results: The VAS scores, total Fentanyl consumption at 24 hours in Group P was less than that of Group C (p < 0.05). Conclusion: PECS provides effective postoperative analgesia for more than 12 hours from T2 to T5 dermatomal levels with opioid sparing effects after breast surgeries with no adverse effects.

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Navyashree Krishnashastry Srinivasa, Sowmya Madihalli Janardhan Iyengar, Kailash Prakash et al. Pectoral Nerve Blocks (PECS) for Postoperative Analgesia after Breast Surgeries: A Randomised Clinical Study. Indian J Anesth Analg. 2019;6(5 P-II):1701-1706.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.30

Keywords

Breast surgery; PECS; Postoperative analgesia; Ultrasound.

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