Pectoral Nerves Blocks for Post-operative Analgesia after Breast Cancer Surgery

Abstract

ffective pain management helps to reduce postoperative complications and leads to early mobilization and faster recovery, there by increasing patient satisfaction and decreasing the cost of care. Analgesia in breast surgeries can be delivered orally, intravenously, intramuscularly, neuroaxial or via regional nerve blocks. Intravenous opioids are mainly administered for acute post operative mastectomy pain but it leads to developmentof many side effects such as sedation, nausea, vomiting and respiratory depression. Thoracic epidural analgesia and paravertebral block become the gold standard techniques for breast surgery but they are associated with serious complications such as pneumothorax and total spinal anesthesia. Pecs blocks in breast surgeries performed under ultrasound guidance are a viable alternative to other more invasive regional anesthetic techniques which carry an increased side effect. The aim of this study was to evaluate the efficacy of ultrasound guided Pectoral neves block for post operative analgesia in modified radical mastectomy surgery. After the approval of the ethical committee of Sohage Cancer Center and provided written informed consent from patients, the present study was carried out on fourty adult female patients who admitted to the Sohage Cancer Center for elective modified radical mastectomy. All patients included in the present study were grade I or II of physical status American Society of Anesthesiologists (ASA). All patients trained to use visual analogue scale to express their pain. All patients arrived to the block room 30 minutes before the operation. The blocks were done after insertion of 20 G peripheral venous catheter and attached to the multichannel monitor for each patient.