The Comparison of Efficacy of Bilateral Type I Versus Type II Pectoral Nerve Block Applied with Ultrasound-Guided for Postoperative Analgesia in Gynecomastia Surgeries.

BACKGROUND

Gynecomastia surgeries are frequently performed due to esthetic concerns. There is lack of data regarding postoperative pain control for these patients. The aim of this study was to compare the pectoral nerve (PECS) block type I and type II with respect to postoperative analgesic consumption, pain scores in these patients.

METHODS

The prospective randomized study was conducted with 30 patients, with American Society of Anesthesiologists I-II, between the ages of 18 and 50, and undergoing bilateral gynecomastia surgery. The patients were divided into two groups: PECS I block with general anesthesia (n = 15) and PECS II block with general anesthesia (n = 15). The demographic data, hemodynamic parameters, postoperative numeric rating scale (NRS) scores (at 0, 1, 2, 6, 12, 24 h postoperative), the number of patients who needed rescue analgesia, and block-related adverse events were recorded.

RESULTS

NRS scores at 30 min, 1 and 2 h postoperatively were similar in the two groups, whereas the scores at 6, 12 and 24 h were significantly lower in the PECS II group (p = 0.005, p = 0.007, p = 0.002, respectively). It was determined that the postoperative 24-h tramadol consumption was statistically significantly lower in the PECS II group (p = 0.005). Additional analgesic was required in two patients in the PECS I group, but none in the PECS II group.

CONCLUSION

PECS blocks could effectively reduce postoperative pain level in gynecomastia operations; however, PECS II block was superior to PECS I block in terms of both analgesic consumption and pain scores.

LEVEL OF EVIDENCE II

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