A randomised controlled study of the post-operative analgesic efficacy of ultrasound-guided pectoral nerve block in the first 24 h after modified radical mastectomy.

BACKGROUND AND AIMS

Breast cancer has become the most common cancer in women worldwide. Acute post-operative pain following mastectomy remains a challenge for the anaesthesiologist despite a range of treatment options available. The present study aimed to compare the post-operative analgesic efficacy of pectoral nerve (Pecs) block performed under ultrasound with our standard practice of opioids and non-steroidal anti-inflammatory drugs for mastectomy.

METHODS

This randomised controlled study was conducted at a tertiary care teaching hospital in India, after obtaining ethical clearance. Fifty adult female patients posted for elective unilateral modified radical mastectomy were divided into two groups as follows: Group I (general anaesthesia only) and Group II (general anaesthesia plus ultrasound-guided Pecs block), each comprising 25 patients. Post-randomisation, patients in Group I received general anaesthesia, while Group II patients received ultrasound-guided Pecs block followed by general anaesthesia after 20 min. The primary outcome was measured as patient-reported pain intensity using Visual Analogue Scale (VAS) at rest. Statistical analysis was performed using Student's -test and Mann-Whitney -test. Data were entered into MS Excel spreadsheet and analysis was performed using the Statistical Package for the Social Sciences version 23.0.

RESULTS

VAS score was significantly lower in Group II at rest and on abduction post-operatively at all time intervals ( < 0.001). The 24-h tramadol consumption was significantly less in Group II compared to Group I (114.4 ± 4.63 mg vs. 402.88 ± 74.22, < 0.0001).

CONCLUSION

Pecs block provided excellent post-operative analgesia in the first 24 h.