A randomized controlled trial of postoperative pain control after subpectoral breast augmentation using intercostal nerve block versus bupivacaine pectoralis major infiltration: A pilot study

Nasr, Marwan; Habre, Samer Bassilios; Jabbour, Hicham; Baradhi, Andre; Asmar, Ziad El

doi:10.1016/j.bjps.2014.12.035

Cited by 5 publications

(2 citation statements)

References 5 publications

(5 reference statements)

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“…Nasr et al compared the intercostal block with direct pectoralis infiltration only using bupivacaine with epinephrine and concluded that neither method significantly improved pain score following submuscular breast augmentation. 17 In contrast, a retrospective study by Jabs et al evaluated the efficacy of tumescent infiltration and bupivacaine injection and found patientreported decreased pain and use of narcotics when compared with a control group that received no intervention. 18 Chaudhry et al used a portable pain pump catheter which was placed within the breast pocket and delivered bupivacaine.…”

Section: Postoperative Pain Controlmentioning

confidence: 99%

Latest Trends in Subpectoral Breast Reconstruction

Winocour

Lemaine³

2019

Seminars in Plastic Surgery

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There has been a shift in recent years toward a growing popularity of implant-based breast reconstruction, especially in the setting of increased frequency of concurrent contralateral prophylactic mastectomy. Advancements in implant safety and technology have also allowed for an expanding implant reconstruction practice across the country. The traditional approach is immediate two-stage implant reconstruction with placement of a tissue expander within a subpectoral pocket. The introduction of acellular dermal matrix has revolutionized implant-based breast reconstruction, allowing surgeons the opportunity to minimize morbidity while maximizing aesthetic outcomes. There have also been advances in the management of postoperative pain control as well as secondary revision surgery.

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Section: Postoperative Pain Controlmentioning

confidence: 99%

Latest Trends in Subpectoral Breast Reconstruction

Winocour

Lemaine³

2019

Seminars in Plastic Surgery

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“…The only prospective study on this infiltration technique compared pectoralis muscle infiltration with the intercostal block for use in submuscular breast augmentation in 28 patients and found no difference between the techniques. 31 Liposomal Bupivacaine and Regional Anesthetic Adjunctive Medications An area of active ongoing research within the regional anesthesia literature is improving block quality and block duration. Numerous medications have been investigated as adjuncts to the local anesthetic solution used for peripheral nerve blocks.…”

Section: Pectoralis Block Versus Pectoralis Muscle Infiltrationmentioning

confidence: 99%

Intraoperative Placement of Pectoral Nerve Block Catheters

Hinchcliff

Hylton

Orbay

et al. 2017

Annals of Plastic Surgery

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Regional and neuraxial anesthesia for pain management after breast surgery is not widely used despite data showing improved postoperative pain control and patient satisfaction scores. We report a case of a 61-year-old woman who underwent bilateral mastectomies, and received postoperative analgesia via pectoral nerves 1 and 2 nerve blocks. This case highlights a previously undescribed technique of prolonged postoperative pain control by intraoperative placement of pectoral nerves 1 and 2 regional anesthesia catheters under direct visualization. Intraoperative placement has the potential benefits of more accurate plane targeting, time saving, and widening the scope of use to practitioners are not trained in the ultrasound guided technique. We also present a review of the regional block techniques and present a preliminary algorithm for the selection of block method in breast surgery.

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