Comparison of the effects of modified pectoral nerve block and erector spinae plane block on postoperative opioid consumption and pain scores of patients after radical mastectomy surgery: A prospective, randomized, controlled trial

Breast cancer is the most common malignancy of women all over the world. In this study, we compared the effects of ultrasound-guided modified pectoral nerve (PECS) block and erector spinae plane (ESP) block on postoperative opioid consumption, pain scores, and intraoperative fentanyl need of patient...

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Bibliographic Details
Published in:Journal of clinical anesthesia Vol. 54; pp. 61 - 65
Main Authors: Altıparmak, Başak, Korkmaz Toker, Melike, Uysal, Ali İhsan, Turan, Mustafa, Gümüş Demirbilek, Semra
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.05.2019
Elsevier Limited
Subjects:
Analgesia
Analgesics
Anesthesia
Blood pressure
Breast cancer
Conflicts of interest
Erector spinae plane block
Intubation
Lymphatic system
Mastectomy
Medical personnel
Modified pectoral nerve block
Narcotics
Pain
Pain Medicine
Patients
Postoperative pain
Researchers
Surgery
Ultrasonic imaging
United States > US
Mastectomy
Analgesia
Postoperative pain
Erector spinae plane block
Modified pectoral nerve block
ISSN:0952-8180, 1873-4529, 1873-4529
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Summary:Breast cancer is the most common malignancy of women all over the world. In this study, we compared the effects of ultrasound-guided modified pectoral nerve (PECS) block and erector spinae plane (ESP) block on postoperative opioid consumption, pain scores, and intraoperative fentanyl need of patients undergoing unilateral modified radical mastectomy surgery. Single-blinded, prospective, randomized, efficacy study. Tertiary university hospital, postoperative recovery room and surgical ward. Forty patients (ASA I–II) were allocated to two groups. After exclusion, 38 patients were included in the final analysis (18 patients in the PECS groups and 20 in the ESP group). Modified pectoral nerve block was performed in the PECS group and erector spinae plane block was performed in the ESP group. Postoperative tramadol consumption and pain scores were compared between the groups. Also, intraoperative fentanyl need was measured. Postoperative tramadol consumption was 132.78 ± 22.44 mg in PECS group and 196 ± 27.03 mg in ESP group (p = 0.001). NRS scores at the 15th and 30th min were similar between the groups. However, median NRS scores were significantly lower in PECS group at the postoperative 60th min, 120th min, 12th hour and 24th hour (p = 0.024, p = 0.018, p = 0.021 and p = 0.011 respectively). Intraoperative fentanyl need was 75 mg in PECS group and 87.5 mg in ESP group. The difference was not statistically significant (p = 0.263). Modified PECS block reduced postoperative tramadol consumption and pain scores more effectively than ESP block after radical mastectomy surgery. •Two thirds of women were found to develop chronic pain after breast cancer surgery.•PECS block reduced postoperative tramadol consumption more effectively than ESP block.•PECS block reduced postoperative pain scores more effectively than ESP block.•Both PECS block and ESP blocks are effective for analgesia after mastectomy surgery.
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ISSN:0952-8180
1873-4529
1873-4529
DOI:10.1016/j.jclinane.2018.10.040