Single-shot pectoral plane (PECs I and PECs II) blocks versus continuous local anaesthetic infusion analgesia or both after non-ambulatory breast-cancer surgery: a prospective, randomised, double-blind trial

O'Scanaill, P.; Keane, Seán; Wall, V.; Flood, Georgina; Buggy, Donal J.

doi:10.1016/j.bja.2017.11.112

Cited by 41 publications

(26 citation statements)

References 18 publications

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“…There are alternative blocks that might be employed for breast surgery , as well as wound infiltration . Regional and local analgesia might be relatively more important in the context of opioid‐sparing methods or in the absence of general anaesthesia .…”

Section: Discussionmentioning

confidence: 99%

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A randomised controlled trial of the pectoral nerves‐2 (PECS‐2) block for radical mastectomy

et al. 2019

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Summary We randomly allocated 50 women scheduled for radical mastectomy to pectoral nerves‐2 (PECS‐2) block (n = 25) or no block (n = 25), 20 and 22 of whom we analysed for the primary outcome of a cumulative 24‐h postoperative morphine dose. We gave intra‐operative sufentanil, magnesium, dexamethasone and droperidol. Participants received regular postoperative paracetamol, ibuprofen and patient‐controlled intravenous morphine. Pectoral nerves‐2 block reduced mean (SD) cumulative 24 h postoperative morphine dose from 9.7 (8.9) mg to 5.0 (5.4) mg and 48 h morphine dose from 12.8 (12.5) mg to 6.0 (6.5) mg, p = 0.04 for both. The mean (SD) pain scores 24 h and 48 h after surgery were similar with or without block: 0.8 (1.4) vs. 1.2 (1.9), p = 0.39; and 0.2 (0.4) vs. 0.9 (1.8), p = 0.09, respectively. Rates of postoperative nausea, vomiting and pruritus were unaffected. Rates of chronic pain at six postoperative months were 2/19 and 2/18 after block and no block, respectively, p = 0.95.

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Section: Discussionmentioning

confidence: 99%

“…There are alternative blocks that might be employed for breast surgery [22][23][24][25], as well as wound infiltration [26].…”

Section: Discussionmentioning

confidence: 99%

A randomised controlled trial of the pectoral nerves‐2 (PECS‐2) block for radical mastectomy

et al. 2019

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“…[ 4 ] Even single-shot regional techniques seem to give excellent early analgesia. [ 5 ] Blocking the sensory supply to breast, axilla, and over the pectoral muscles provides adequate analgesia in the postoperative period. In our study the first injection of 20 ml below pectoralis minor so as to infiltrate the serratus anterior fascia and spread the injectate into the axilla at the level of third rib addressed the sensory supply of the breast, which is mainly derived from the branches of thoracic intercostal nerves T2–T5 and the axilla supplied by the long thoracic nerve and thoracodorsal nerve.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative pectoral nerve block (Pec) for breast cancer surgery: A randomized controlled trial

Thomas

Philip

Mathew

et al. 2018

J Anaesthesiol Clin Pharmacol

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“…Although a small amount of LAs may reduce LAs-related complications, continuous catheterization may be required to prolong blockade duration with a low concentration of LAs in order to meet postoperative analgesia needs. 16 Compared with a single-shot block, continuous LAs infusion may increase the risk of catheterrelated infections 17,18 and delay the patient's early postoperative activity. Therefore, we expected to determine the appropriate LAs concentration for a single-shot block to…”

Section: Discussionmentioning

confidence: 99%

<p>Effects of Ropivacaine Concentration on Analgesia After Ultrasound-Guided Serratus Anterior Plane Block: A Randomized Double-Blind Trial</p>

Huang¹,

Zheng²,

Wu³

et al. 2020

JPR

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Serratus anterior plane (SAP) block is effective for analgesia after breast surgery. Whether a higher local anesthetic concentration prolongs sensory block duration and improves postoperative analgesia remains unclear. The aim of this study was to compare the analgesic effects of SAP block with different concentrations of ropivacaine. Patients and Methods: Sixty patients scheduled for breast surgery were enrolled in this randomized double-blind trial. SAP block was induced with 20 mL of 0.375%, 0.5%, or 0.75% ropivacaine in Group R0.375, Group R0.5, and Group R0.75, respectively. The primary endpoint was the area under the curve (AUC) of numerical rating scale (NRS) pain intensity scores at rest over time. The secondary endpoints were AUC of NRS pain intensity scores on movement over time, active sensory block duration, tramadol consumption, and the elapsed time between completion of surgery and the first administration of rescue analgesia. Results: The AUC of NRS pain intensity scores at rest of Group R0.375 was significantly higher than that of Groups R0.5 and R0.75 (P=0.025, and P=0.001). The AUC of NRS pain intensity scores on movement of Group R0.375 was also significantly higher than that of Groups R0.5 and R0.75 (both P<0.001). At higher ropivacaine concentrations, the duration of SAP sensory block increased (P<0.001). Tramadol consumption and the elapsed time between completion of surgery and the first administration of rescue analgesia were similar in the three groups (P>0.05). Conclusion: A comparison of 0.5% and 0.75% ropivacaine showed no significant difference in postoperative analgesia, but both were superior to 0.375% ropivacaine, although higher ropivacaine concentration lengthened the duration of SAP block. Therefore, SAP block with 0.5% ropivacaine is recommended for postoperative analgesia in breast surgery.

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Single-shot pectoral plane (PECs I and PECs II) blocks versus continuous local anaesthetic infusion analgesia or both after non-ambulatory breast-cancer surgery: a prospective, randomised, double-blind trial

Abstract: NCT 03024697.

Cited by 41 publications

References 18 publications

A randomised controlled trial of the pectoral nerves‐2 (PECS‐2) block for radical mastectomy

A randomised controlled trial of the pectoral nerves‐2 (PECS‐2) block for radical mastectomy

Intraoperative pectoral nerve block (Pec) for breast cancer surgery: A randomized controlled trial

<p>Effects of Ropivacaine Concentration on Analgesia After Ultrasound-Guided Serratus Anterior Plane Block: A Randomized Double-Blind Trial</p>

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