• J Clin Anesth · Aug 2017

    Randomized Controlled Trial

    Prospective double blind randomized placebo-controlled clinical trial of the pectoral nerves (Pecs) block type II.

    • Barbara Versyck, Geert-Jan van Geffen, and Patrick Van Houwe.
    • GZA Sint-Augustinus, Oosterveldlaan 24, 2610 Wilrijk, Belgium. Electronic address: barbara.versyck@uzleuven.be.
    • J Clin Anesth. 2017 Aug 1; 40: 46-50.

    Study ObjectiveThe aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery.DesignA prospective randomized double blind placebo-controlled study.SettingA secondary hospital.Patients140 breast cancer stage 1-3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection.InterventionsPatients were randomized to receive either a Pecs block with levobupivacaine 0.25% (n=70) or placebo block with saline (n=70).MeasurementsThe pain levels were evaluated by Numeric Rating Scale (NRS) pain scores at 15-minute intervals during the post anesthesia care unit stay time (PACU), at 2-hour intervals for the first 24h on the ward and at 4-hour intervals for the next 24h. Intraoperative and postoperative opioid consumption were recorded during the full stay. Patient satisfaction was evaluated upon discharge using a 10-point scale.Main ResultsIntraoperative sufentanil requirements were comparable for the Pecs and placebo group (8.0±3.5μg and 7.8±3.0μg, P=0.730). Patients in the Pecs group experienced significantly less pain than patients in the control group (P=0.048) during their PACU stay. Furthermore, patients in the Pecs group required significant less postoperative opioids (9.16±10.15mg and 14.97±14.38mg morphine equivalent, P=0.037) and required significant fewer postsurgical opioid administration interventions than patients in the control group (P=0.045). Both patient-groups were very satisfied about their management (9.6±0.6 and 9.1±1.8 on a 10-point scale, P=0.211).ConclusionsThe Pecs block reduces postsurgical opioid consumption during the PACU stay time for patients undergoing breast surgery.Copyright © 2017 Elsevier Inc. All rights reserved.

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