Key result
Preoperative ultrasound-guided Pectoral nerves blocks significantly reduced post-operative VAS scores and 24-hour nalbuphine consumption compared to general anesthesia alone.
Why the study?
Several methods are used to prevent post-mastectomy pain, but the efficacy of ultrasound-guided pectoral nerves blocks for post-operative analgesia required evaluation.
Does preoperative ultrasound-guided Pectoral nerves block improve post-operative analgesia in adult female patients undergoing modified radical mastectomy?
RCT (n=40)
Randomly assigned
Does preoperative ultrasound-guided Pectoral nerves block improve post-operative analgesia in adult female patients undergoing modified radical mastectomy?
Ultrasound-guided Pecs blocks combined with general anesthesia significantly reduce post-operative pain and opioid consumption compared to general anesthesia alone in patients undergoing modified radical mastectomy.
Answers are grounded in this paper and cite their sources.
Supports routine Pecs block use for mastectomy analgesia; confirms RCT-level benefit of regional adjuncts in breast surgery.
Background: Breast cancer is the world's most commoncancer among women, surgey is one of the main treatmentsfor this disease. Several ways to prevent post mastectomypain were used, one of them is the pectoral nerves blocks (PECs Blocks).Aim of Study: Study aimed to evaluate the efficacy ofultrasound guided Pectoral neves blocks for post-operativeanalgesia after modified radical mastectomy surgery.Patients and Methods: The study was carried out on fourtyadult female patients, who were scheduled for elective unilat-eral modified radical mastectomy, they were randomly assignedto two groups, Pectoral nerves block (Pecs) group, includedtwenty patients who received preoperative Pecs blocks (com-bination of Pecs I and Pecs II) followed by general anesthesia,and control group which included twenty patients who receivedgeneral anesthesia only.Results: It was found that VAS score was statisticallysignificant higher in control group than Pecs group. Therewas a significant difference concerning the total dose ofnalbuphine consumption in 24 hours post-operative betweenboth groups which is lower in Pecs group than in controlgroup. There was a higher satisfaction scores were obtainedin Pecs group than in control group with no detected compli-cations other than PONV.Conclusion: The Pecs blocks produce excellent analgesiawhen combined with general anesthesia for modified radicalmastectomy surgery. They are simple, easy-to-learn techniques,having easily identifiable landmarks based on good anatomicaland ultrasound knowledge, making them an excellent alterna-tive to the conventional thoracic paravertebral and neuroaxialblocks for breast surgeries. Also ultrasound guided Pecs blockssignificantly reduces VAS.
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Younis et al. (2021) conducted an RCT in Breast cancer (n=40). Pectoral nerves blocks (Pecs I and Pecs II) vs. General anesthesia only was evaluated on VAS score and total dose of nalbuphine consumption in 24 hours post-operative. Preoperative ultrasound-guided Pectoral nerves blocks significantly reduced post-operative VAS scores and 24-hour nalbuphine consumption compared to general anesthesia alone.
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