Addition of PECS Block to Multimodal Analgesia for Postoperative Analgesia after Breast Cancer Surgery: A Randomized Clinical Trial

Abstract

: Background: Postoperative pain can seriously reduce the quality of life in patients, and acute pain can even trigger chronic pain syndrome. We aimed to compare efficacy of adding PECS block under general anesthesia with preoperative oral multimodal Analgesia (MMA) or alone on postoperative opioid consumption in subjects undergoing breast surgery. Methods: This prospective double-blinded randomized controlled study was conducted on 120 adult women underwent breast surgeries. Patients were randomly allocated into 3 equal groups; group I, only MMA was administered, group II; both PECS and MMA were administered and group III only PECS was administered. All patients were evaluated full clinical assessment and laboratory investigations. In group I, preoperative MMA with oral acetaminophen 975 mg and/or gabapentin 600 mg as preventive analgesia was given within 2 hours prior to surgery. Results: There was an insignificant difference among the studied groups regarding the VAS at all time measurement and perioperative opioid consumption. The incidence of PONV and the need for PONV rescue medication were significantly different among the studied group, being less prevalent in group C followed by group B (P=0.001, 0.001). Conclusions: We found comparable results in the postoperative VAS score and perioperative opioid consumption suggesting that the use of PECS block combined with MMA may not reduce intraoperative and/or postoperative opioid consumption in subjects undergoing elective breast surgery. However, the incidence of PONV was less prevalent in PECS group followed by PECS block combined with MMA.