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. 2021 Nov 10;11(5):e119440.
doi: 10.5812/aapm.119440. eCollection 2021 Oct.

Pain Control After Mastectomy in Transgender Patients: Ultrasound-guided Pectoral Nerve Block II Versus Conventional Intercostal Nerve Block: A Randomized Clinical Trial

Faranak Rokhtabnak  1 , Soheila Sayad  2 , Maryam Izadi  1 , Soudabeh Djalali Motlagh  1 , Poupak Rahimzadeh  3
Affiliations

Pain Control After Mastectomy in Transgender Patients: Ultrasound-guided Pectoral Nerve Block II Versus Conventional Intercostal Nerve Block: A Randomized Clinical Trial

Faranak Rokhtabnak et al. Anesth Pain Med. .

Abstract

Background: Mastectomy is sometimes performed in transgender patients, which may damage the regional nerves such as the pectoral and intercostobrachial nerves, leading to postoperative pain. An ultrasound-guided nerve block can be used to track and block the nerves properly.

Objectives: This study aimed to compare the ultrasound-guided type-II pectoral nerve block with the blind (conventional) intercostal nerve block (ICNB) for pain control after breast tissue reconstruction surgery in transgender patients.

Methods: In the present single-blind randomized clinical trial, 47 patients were randomly divided into two groups: (A) Ultrasound-guided type-II pectoral nerve block (n = 23) and (B) blind intercostal nerve block (n = 24). After nerve block in both groups, pain intensity at 3, 6, 12, and 24 hours after surgery, upper limb paresthesia, frequency of nausea and vomiting, shortness of breath, hematoma, and the length of hospital stay were assessed.

Results: Patients who received the ultrasound-guided type-II pectoral nerve block had a greater reduction in pain intensity (24 h after surgery), opioid use (24 h after surgery), nausea, vomiting, and hospital stay than those who received ICNB, whereas the recovery time did not differ between the study groups.

Conclusions: The pectoral nerve block under ultrasound guidance, compared to the intercostal nerve block, in transgender patients can reduce the required dosage of opioids within 24 hours, pain intensity within 24 hours after surgery, the incidence of postoperative nausea, and vomiting, and the hospital stay of patients.

Keywords: Intercostal Nerve Block; Mastectomy; Pectoral Nerve Block; Transgender; Ultrasound Guidance.

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Conflict of interest statement

Conflict of Interests: The authors declare that there were no conflicts of interest.

Figures

Figure 1.
Figure 1.. Consort flow diagram of the present clinical trial
Figure 2.
Figure 2.. The trend of postoperative pain score changes in patients in the two study groups
See this image and copyright information in PMC

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