Role of pectoral nerve block (PECS II) in post-operative pain management for breast surgeries

Background: Pain after breast surgeries is a major problem which costs both in patient comfort and duration of hospital stay. Uncontrolled post-operative pain may produce a range of detrimental acute and chronic effects. Optimal pain relief and minimal side effects following surgery have a major imp...

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Main Authors: Mili Yadav, Amey Dixit, Arvind Kumar Rathiya, Subhash Kumar Agrawal
Format: Article
Language:English
Published: Manipal College of Medical Sciences, Pokhara 2022-10-01
Series:Asian Journal of Medical Sciences
Subjects:
Online Access:https://www.nepjol.info/index.php/AJMS/article/view/45812
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author Mili Yadav
Amey Dixit
Arvind Kumar Rathiya
Subhash Kumar Agrawal
author_facet Mili Yadav
Amey Dixit
Arvind Kumar Rathiya
Subhash Kumar Agrawal
author_sort Mili Yadav
collection DOAJ
description Background: Pain after breast surgeries is a major problem which costs both in patient comfort and duration of hospital stay. Uncontrolled post-operative pain may produce a range of detrimental acute and chronic effects. Optimal pain relief and minimal side effects following surgery have a major impact on patient outcome, including patient satisfaction and earlier mobilization, as well as fulfilling the needs for streamlined surgical services with lower costs. Aims and Objectives: The aim of the study was to assess for the pain score during the first 24 h with time of the first request for rescue analgesic and total analgesic requirement and also to assess the patient‘s satisfaction for post-operative pain relief and consequences if any during the first 24 h. Materials and Methods: This prospective study was conducted in 60 patients of ASA status I or II considering for mastectomy categorized into two groups, the first group with 30 patients who received Bupivacaine drug and second group with 30 patients who received normal saline. In the PACU, each patient’s VAS score and tramadol use were evaluated. The pectoral nerve block is a less invasive interfacial plane block used for post-operative pain relief in breast surgeries that involves deposition of local anesthetic between the pectoralis major and minor muscles, in addition to the serratus anterior and pectoralis minor muscles and the intercostal muscles, blocking the lateral branches of the intercostal nerves and the long thoracic nerve. Results: We found a significant difference in total rescue analgesia intake among control and PECS II block groups, in an initial 24 h of surgery. In the control group, mean VAS score and total rescue analgesia intake in 24 h were statistically significant greater (P<0.05). Conclusion: We concluded that pectoral nerve block is an effective and easy technique for pain control and fast recovery in post-operative period following breast surgeries.
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spelling doaj.art-9eb6b5d7cfd943bb92b24805020a171f2022-12-22T03:23:41ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762022-10-0113105965https://doi.org/10.3126/ajms.v13i10.45812Role of pectoral nerve block (PECS II) in post-operative pain management for breast surgeriesMili Yadav 0https://orcid.org/0000-0002-1549-0562Amey Dixit 1https://orcid.org/0000-0001-7627-0048Arvind Kumar Rathiya 2https://orcid.org/0000-0003-4421-605XSubhash Kumar Agrawal 3https://orcid.org/0000-0001-8502-2169Postgraduate Resident, Department of Anaesthesiology, Shyam Shah Medical College, Rewa, Madhya Pradesh, India Senior Resident, Department of Anaesthesiology, Shyam Shah Medical College, Rewa, Madhya Pradesh, India Associate Professor, Department of Anaesthesiology, Shyam Shah Medical College, Rewa, Madhya Pradesh, India Professor, Department of Anaesthesiology, Superspeciality Hospital, Shyam Shah Medical College, Rewa, Madhya Pradesh, India Background: Pain after breast surgeries is a major problem which costs both in patient comfort and duration of hospital stay. Uncontrolled post-operative pain may produce a range of detrimental acute and chronic effects. Optimal pain relief and minimal side effects following surgery have a major impact on patient outcome, including patient satisfaction and earlier mobilization, as well as fulfilling the needs for streamlined surgical services with lower costs. Aims and Objectives: The aim of the study was to assess for the pain score during the first 24 h with time of the first request for rescue analgesic and total analgesic requirement and also to assess the patient‘s satisfaction for post-operative pain relief and consequences if any during the first 24 h. Materials and Methods: This prospective study was conducted in 60 patients of ASA status I or II considering for mastectomy categorized into two groups, the first group with 30 patients who received Bupivacaine drug and second group with 30 patients who received normal saline. In the PACU, each patient’s VAS score and tramadol use were evaluated. The pectoral nerve block is a less invasive interfacial plane block used for post-operative pain relief in breast surgeries that involves deposition of local anesthetic between the pectoralis major and minor muscles, in addition to the serratus anterior and pectoralis minor muscles and the intercostal muscles, blocking the lateral branches of the intercostal nerves and the long thoracic nerve. Results: We found a significant difference in total rescue analgesia intake among control and PECS II block groups, in an initial 24 h of surgery. In the control group, mean VAS score and total rescue analgesia intake in 24 h were statistically significant greater (P<0.05). Conclusion: We concluded that pectoral nerve block is an effective and easy technique for pain control and fast recovery in post-operative period following breast surgeries.https://www.nepjol.info/index.php/AJMS/article/view/45812mastectomy; pectoral nerve block; postoperative analgesia
spellingShingle Mili Yadav
Amey Dixit
Arvind Kumar Rathiya
Subhash Kumar Agrawal
Role of pectoral nerve block (PECS II) in post-operative pain management for breast surgeries
Asian Journal of Medical Sciences
mastectomy; pectoral nerve block; postoperative analgesia
title Role of pectoral nerve block (PECS II) in post-operative pain management for breast surgeries
title_full Role of pectoral nerve block (PECS II) in post-operative pain management for breast surgeries
title_fullStr Role of pectoral nerve block (PECS II) in post-operative pain management for breast surgeries
title_full_unstemmed Role of pectoral nerve block (PECS II) in post-operative pain management for breast surgeries
title_short Role of pectoral nerve block (PECS II) in post-operative pain management for breast surgeries
title_sort role of pectoral nerve block pecs ii in post operative pain management for breast surgeries
topic mastectomy; pectoral nerve block; postoperative analgesia
url https://www.nepjol.info/index.php/AJMS/article/view/45812
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AT arvindkumarrathiya roleofpectoralnerveblockpecsiiinpostoperativepainmanagementforbreastsurgeries
AT subhashkumaragrawal roleofpectoralnerveblockpecsiiinpostoperativepainmanagementforbreastsurgeries