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 IJCM  Vol.8 No.3 , March 2017
PECS Block Provides Effective Postoperative Pain Management for Breast Cancer Surgery—A Retrospective Study
Ichikawa Yuki1, Hironobu Ueshima2*, Hiroshi Otake2, Akira Kitamura1
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Abstract: We investigated the efficacy of ultrasound-guided pectoral nerves (PECS) block for modified radical mastectomy surgery retrospectively. Methods: We measured that pain scores and the use of additional analgesic drugs were recorded in the postoperative care unit within 24 hours after the operation. Postoperative complications (i.e., nausea and vomiting) were noted. Results: Patients who received the PECS block under general anesthesia (PECS group) reported lower visual analog scale pain scores at 0, 1, 2, 4, 6, 12, 24 hours after the operation than patients who did not receive PECS block under general anesthesia (control group). Moreover, the use of additional analgesic drugs during the first 24 hours after surgery was lower in the PECS group than in the control group. While in the postoperative care unit, the PECS group had less nausea and vomiting than the control group. Conclusion: The PECS block provides effective postoperative analgesia within the first 24 hours after breast cancer surgery.
Keywords: Pectoral Nerves Block, Postoperative Pain Management, Breast Cancer Surgery
Cite this paper: Yuki, I. , Ueshima, H. , Otake, H. and Kitamura, A. (2017) PECS Block Provides Effective Postoperative Pain Management for Breast Cancer Surgery—A Retrospective Study. International Journal of Clinical Medicine, 8, 198-203. doi: 10.4236/ijcm.2017.83019.
References

[1]   Gärtner, R., Jensen, M.B., Nielsen, J., Ewertz, M., Kroman, N. and Kehlet, H. (2009) Prevalence of and factors Associated with Persistent Pain Following Breast Cancer Surgery. JAMA, 302, 1985-1992.
https://doi.org/10.1001/jama.2009.1568

[2]   Wijayasinghe, N., Andersen, K.G. and Kehlet, H. (2014) Neural Blockade for Persistent Pain after Breast Cancer Surgery. Regional Anesthesia and Pain Medicine, 39, 272-278.
https://doi.org/10.1097/AAP.0000000000000101

[3]   Scjnabel, A., Reichl, S.U., Kranke, P. and Pogatzki-Zahn, P.K. (2010) Efficacy and safety of Paravertebral Blocks in Breast Surgery: A Meta-Analysis of Randomized Controll Trials. British Journal of Anaesthesia, 105, 842-852.
https://doi.org/10.1093/bja/aeq265

[4]   Sundarathiti, P., Pasutharnchat, K., Kongdan, Y. and Suranutkarin, P. (2005) Thoracic Epidural Anesthesia with 0.2% Ropivacaine in Combination with Ipsilateral Brachial Plexus Block for Modified Radical Mastectomy. Journal of the Medical Association of Thailand, 88, 513-320.

[5]   Blanco, R. (2011) The “Pecs Block”: A Novel Technique for Privyding Analgesia after Breast Surgery. Anaesthesia, 66, 847-848.
https://doi.org/10.1111/j.1365-2044.2011.06838.x

[6]   Blanco, R., Fajardo, M. and Parra Maldonado, T. (2012) Ultrasound Descrytion of PecsII (Modified PecsI): A Novel Approach to Breast Surgery. Revista Española de Anestesiología y Reanimación, 59, 470-475.
https://doi.org/10.1016/j.redar.2012.07.003

[7]   Bashandy, G.M.N. and Abbas, D.N. (2015) Pectoral Nerves I and II Blocks in Multimodal Analgesia for Breast Cancer Surgery. Regional Anesthesia and Pain Medicine, 40, 68-74.
https://doi.org/10.1097/AAP.0000000000000163

[8]   Fearon, K.C., Ljungqvist, O., Von Meyenfeldt, M., Revhaug, A., Dejong, C.H., Lassen, K., Nygren, J., Hausel, J., Soop, M., Andersen, J. and Kehlet, H. (2005) Enhanced Recovery after Surgery: A Consensus Review of Clinical Care for Patients Undergoing Colonic Resection. Clinical Nutrition, 24, 466-477.
https://doi.org/10.1016/j.clnu.2005.02.002

[9]   Rodgers, A., Walker, N., Schug, S., McKee, A., Kehlet, H., van Zundert, A., Sage, D., Futter, M., Saville, G., Clark, T. and MacMahon, S. (2000) Reduction of Postoperative Mortality and Morbidity with Epidural or Spinal Anaesthesia: Results from Overview of Randomised Trials. BMJ, 16, 321.

[10]   Chang, C.C., Lin, H.C., Lin, H.W. and Lin, H.C. (2010) Anesthetic Management and Surgical Site Infections in Total Hip or Knee Replacement: A Population-Based Study. Anesthesiology, 13, 279-284.
https://doi.org/10.1097/ALN.0b013e3181e2c1c3

[11]   Biki, B., Mascha, E., Moriarty, D.C., Fitzpatrick, J.M., Sessler, D.I. and Buggy, D.J. (2008) Anesthetic Technique for Radical Proatatectomy Surgery Affects Cancer Recurrence: A Retrospective Analysis. Anesthesiology, 109, 180-187.
https://doi.org/10.1097/ALN.0b013e31817f5b73

[12]   Dioone, R. (2000) Preemptive vs Preventive Analgesia: Which Approach Improves Clinical Outcomes? Compendium of Continuing Education in Dentistry, 21, 48, 51-54.

[13]   Ueshima, H. and Kitamura, A. (2015) Blocking of Multiple Anterior Branches of Intercoatal Nerves (Th2-6) Using a Transversus Thoracic Muscle Plane Block. Regional Anesthesia and Pain Medicine, 40, 388.
https://doi.org/10.1097/AAP.0000000000000245

[14]   Fujiwara, A., Komasawa, N. and Minami, T. (2014) Pectoral Nerves (PECS) and Intercostal Nerve Block for Cardiac Resynchronization Therapy Device Implantation. SpringerPlus, 5, 409.
https://doi.org/10.1186/2193-1801-3-409

[15]   Murata, H., Ichinomiya, T. and Hara, T. (2015) Pecs Block for Anesthesia in Breast Surgery of Elderly. Journal of Anesthesia, 29, 644.
https://doi.org/10.1007/s00540-015-1992-1

 
 
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