The efficacy of ultrasound-guided type-I and type-II pectoral nerve blocks for postoperative analgesia after breast augmentation: A prospective, randomised study

Abstract

Purpose: The present study was planned to evaluate the efficacy and safety of ultrasound-guided Pecs I and II blocks for postoperative analgesia after sub-pectoral breast augmentation.

Methods: Fifty-four adult female patients undergoing breast augmentation were randomly divided into two groups: the control group (Group C, n = 27) who were not subjected to block treatment and Pecs group (Group P, n = 27) who received Pecs I (bupivacain 0.25%, 10 mL) and Pecs II (bupivacain 0.25%, 20 mL) block. Patient-controlled fentanyl analgesia was used for postoperative pain relief in both groups, and the patients were observed for the presence of any block-related complications.

Results: The 24-h fentanyl consumption was smaller in Group P [mean +/- SD, 378.7 +/- 54.0 mu g and 115.7 +/- 98.1 mu g, respectively; P < 0.001]. VAS scores in Group P were significantly lower at the time of admission to the post-anaesthetic care unit and at 1, 2, 4, 8, 12, and 24 h (P < 0.001). The rates of nausea and vomiting were higher in Group C than in Group P (9 vs 2, P = 0.018). Hospital stay duration was shorter in Group P than in Group C (24.4 +/- 1.2 h vs 27.0 +/- 3.1 h, P < 0.001). No block-related complications were recorded.

Conclusions: Combine used of Pecs I and II blocks provide superior postoperative analgesia in patients undergoing breast augmentation and shortens hospital stay. (C) 2018 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.