Ultrasound-guided modified pectoral plane (PECS II) block versus erector spinae plane (ESP) block for perioperative analgesia of surgical treatment of gynecomastia

Abstract Background Nerve block reduces anesthetics requirement, allows faster recovery, and reduces postoperative pain. The modified pectoral plane block (PECS II) and the erector spinae plane block (ESP) have been proposed for nerve block in men undergoing breast surgery for gynecomastia. This stu...

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Main Authors: Manal Mohamed Rashad, Anas Ahmed Abdelhay
Format: Article
Language:English
Published: SpringerOpen 2022-12-01
Series:Ain Shams Journal of Anesthesiology
Subjects:
Online Access:https://doi.org/10.1186/s42077-022-00295-2
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author Manal Mohamed Rashad
Anas Ahmed Abdelhay
author_facet Manal Mohamed Rashad
Anas Ahmed Abdelhay
author_sort Manal Mohamed Rashad
collection DOAJ
description Abstract Background Nerve block reduces anesthetics requirement, allows faster recovery, and reduces postoperative pain. The modified pectoral plane block (PECS II) and the erector spinae plane block (ESP) have been proposed for nerve block in men undergoing breast surgery for gynecomastia. This study aimed to compare the efficacy of PECS II and ESP for perioperative analgesia in men undergoing surgical treatment of gynecomastia. We conducted a randomized clinical trial on 46 males (with ASA I and II, age range from 18 to 25 years) undergoing surgical gynecomastia treatment in a tertiary medical center. Patients were randomly allocated to receive nerve blocks with either PECS II or ESP in addition to the general anesthesia. The postoperative opioid requirement, analgesic doses, pain intensity on the VAS score, hemodynamic parameters throughout the operation, and complications were recorded and compared for both groups. Results PECS II group had more favorable outcomes compared to the ESP group, evident by the significantly less total morphine consumption in 24 h (6.09 vs. 14.26 mg, P ≤ 0.001) and the significantly higher effective analgesic time (6.57 vs. 4.91 h, P ≤ 0.001). In addition, there were no intraoperative or postoperative complications recorded in both groups. Conclusions For men undergoing elective surgical treatment of gynecomastia, the ultrasound-guided modified PECS II is superior to the ESP in terms of opioid requirement, analgesic doses, and pain intensity.
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spelling doaj.art-23ab123e41c442c992c05b533735f9ef2023-01-01T12:13:28ZengSpringerOpenAin Shams Journal of Anesthesiology2090-925X2022-12-011411910.1186/s42077-022-00295-2Ultrasound-guided modified pectoral plane (PECS II) block versus erector spinae plane (ESP) block for perioperative analgesia of surgical treatment of gynecomastiaManal Mohamed Rashad0Anas Ahmed Abdelhay1Department of Anaesthesiology and Surgical Intensive Care, Faculty of Medicine, Zagazig UniversityDepartment of Anaesthesiology and Surgical Intensive Care, Ahmed Maher Teaching Hospital, Egypt Ministry of Health and PopulationAbstract Background Nerve block reduces anesthetics requirement, allows faster recovery, and reduces postoperative pain. The modified pectoral plane block (PECS II) and the erector spinae plane block (ESP) have been proposed for nerve block in men undergoing breast surgery for gynecomastia. This study aimed to compare the efficacy of PECS II and ESP for perioperative analgesia in men undergoing surgical treatment of gynecomastia. We conducted a randomized clinical trial on 46 males (with ASA I and II, age range from 18 to 25 years) undergoing surgical gynecomastia treatment in a tertiary medical center. Patients were randomly allocated to receive nerve blocks with either PECS II or ESP in addition to the general anesthesia. The postoperative opioid requirement, analgesic doses, pain intensity on the VAS score, hemodynamic parameters throughout the operation, and complications were recorded and compared for both groups. Results PECS II group had more favorable outcomes compared to the ESP group, evident by the significantly less total morphine consumption in 24 h (6.09 vs. 14.26 mg, P ≤ 0.001) and the significantly higher effective analgesic time (6.57 vs. 4.91 h, P ≤ 0.001). In addition, there were no intraoperative or postoperative complications recorded in both groups. Conclusions For men undergoing elective surgical treatment of gynecomastia, the ultrasound-guided modified PECS II is superior to the ESP in terms of opioid requirement, analgesic doses, and pain intensity.https://doi.org/10.1186/s42077-022-00295-2AnalgesiaErector spinae blockGynecomastiaPectoral nerve blockUltrasoundSurgery
spellingShingle Manal Mohamed Rashad
Anas Ahmed Abdelhay
Ultrasound-guided modified pectoral plane (PECS II) block versus erector spinae plane (ESP) block for perioperative analgesia of surgical treatment of gynecomastia
Ain Shams Journal of Anesthesiology
Analgesia
Erector spinae block
Gynecomastia
Pectoral nerve block
Ultrasound
Surgery
title Ultrasound-guided modified pectoral plane (PECS II) block versus erector spinae plane (ESP) block for perioperative analgesia of surgical treatment of gynecomastia
title_full Ultrasound-guided modified pectoral plane (PECS II) block versus erector spinae plane (ESP) block for perioperative analgesia of surgical treatment of gynecomastia
title_fullStr Ultrasound-guided modified pectoral plane (PECS II) block versus erector spinae plane (ESP) block for perioperative analgesia of surgical treatment of gynecomastia
title_full_unstemmed Ultrasound-guided modified pectoral plane (PECS II) block versus erector spinae plane (ESP) block for perioperative analgesia of surgical treatment of gynecomastia
title_short Ultrasound-guided modified pectoral plane (PECS II) block versus erector spinae plane (ESP) block for perioperative analgesia of surgical treatment of gynecomastia
title_sort ultrasound guided modified pectoral plane pecs ii block versus erector spinae plane esp block for perioperative analgesia of surgical treatment of gynecomastia
topic Analgesia
Erector spinae block
Gynecomastia
Pectoral nerve block
Ultrasound
Surgery
url https://doi.org/10.1186/s42077-022-00295-2
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