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. 2019 Oct 25:48:65-68.
doi: 10.1016/j.amsu.2019.10.019. eCollection 2019 Dec.

The role of pectoral nerve blocks in a day-case mastectomy service: A prospective cohort study

Ashleigh Bell  1 , Oroog Ali  1 , Amy Robinson  1 , Amitabh Aggarwal  1 , Michael Blundell  1 , Alice Townend  1 , Sebastian Aspinall  1
Affiliations

The role of pectoral nerve blocks in a day-case mastectomy service: A prospective cohort study

Ashleigh Bell et al. Ann Med Surg (Lond). .

Abstract

Background: It is now recognised that the majority of breast surgery can be safely undertaken as day case procedures. We aimed to evaluate the effect of pectoral nerve (Pecs2) blocks on recovery parameters and day case rates in patients undergoing mastectomy for breast cancer.

Methods: A prospective cohort study was performed in a single NHS Foundation trust between 1st April 2014 and 31st December 2016. Visual analogue scale (VAS) pain scores (0-10) at 4 and 8 h, episodes of post-operative nausea ± vomiting (PONV), opioid use and day case outcome were compared between Pecs2 and no Pecs2 groups.

Results: 22 patients underwent general anaesthesia (GA) + Pecs2 block and 30 GA ± local anaesthetic infiltration.Mean pain scores were significantly lower in the Pecs2 (2.5) vs no Pecs2 (4.6) group at 4 h (p = 0.0132) and 8 h, Pecs2 (1.9) vs no Pecs2 (3.6) (p = 0.0038).Episodes of PONV requiring additional anti-emetic were lower and statistically significant in the Pecs2 group (2/22, 9%) than the no Pecs2 group (14/30, 46%), (p = 0.005).Additional opioid use was significantly lower in the Pecs2 group (4/22, 18%) than in the no Pecs2 group (14/30, 46%) (p = 0.0423).18 patients in the Pecs2 group were discharged the same day in contrast to just 3 patients in the no Pecs2 group. This was highly statistically significant (p = 0.0001).

Conclusions: Pecs2 blocks can significantly reduce post-operative pain, nausea and vomiting in patients undergoing mastectomy. Their use can enable units to achieve high day-case mastectomy rates.

Keywords: Ambulatory surgery; Breast cancer; Mastectomy; Nerve block; Pectoralis muscles; Simple.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Recovery parameters and day case outcome, no Pecs2 vs Pecs2.
See this image and copyright information in PMC

References

    1. Cancer research UK Cancer statistics reports for the UK. https://www.cancerresearchuk.org/health-professional/cancer-statistics/s... accessed Sept 1st 2017.
    1. Garg R., Bhan S., Vig S. Newer regional analgesia interventions (fascial plane blocks) for breast surgeries: review of literature. Indian J. Anaesth. 2018;62:254–262. - PMC - PubMed
    1. Pectoralis and serratus plane blocks. https://www.nysora.com/regional-anesthesia-for-specific-surgical-procedu... accessed Sept 1st 2017.
    1. Agha R.A., Borrelli M.R., Vella-Baldacchino M., Thavayogan R., Orgill D.P., for the STROCSS Group The STROCSS statement: strengthening the reporting of cohort studies in surgery. Int. J. Surg. 2017;46:198–202. - PMC - PubMed
    1. Versyck B., van Geffen G.J.2, Van Houwe P3 Prospective double blind randomised placebo-controlled clinical trial of the pectoral nerves (Pecs) block type II. J. Clin. Anesth. 2017 Aug;40:46–50. - PubMed