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Pectoral Nerves I and II Blocks in Multimodal Analgesia for Breast Cancer Surgery: A Randomized Clinical Trial
  1. Ghada Mohammad Nabih Bashandy, MD and
  2. Dina Nabil Abbas, MD
  1. From the Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt
  1. Address correspondence to: Ghada Mohammad Nabih Bashandy, MD National Cancer Institute, Cairo University, Fom Al-Khalij, KasrAleiny St, Cairo, Egypt (e-mail: Ghada_pashandy{at}


Background The pectoral nerves (Pecs) block types I and II are novel techniques to block the pectoral, intercostobrachial, third to sixth intercostals, and the long thoracic nerves. They may provide good analgesia during and after breast surgery. Our study aimed to compare prospectively the quality of analgesia after modified radical mastectomy surgery using general anesthesia and Pecs blocks versus general anesthesia alone.

Methods One hundred twenty adult female patients scheduled for elective unilateral modified radical mastectomy under general anesthesia were randomly allocated to receive either general anesthesia plus Pecs block (Pecs group, n = 60) or general anesthesia alone (control group, n = 60).

Results Statistically significant lower visual analog scale pain scores were observed in the Pecs group than in the control group patients. Moreover, postoperative morphine consumption in the Pecs group was lower in the first 12 hours after surgery than in the control group. In addition, statistically significant lower intraoperative fentanyl consumption was observed in the Pecs group than in the control group. In the postanesthesia care unit, nausea and vomiting as well as sedation scores were lower in the Pecs group compared with the control group. Overall, postanesthesia care unit and hospital stays were shorter in the Pecs group than in the control group.

Conclusions The combined Pecs I and II block is a simple, easy-to-learn technique that produces good analgesia for radical breast surgery.

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  • Funding from the National Cancer Institute, Cairo University, helped support this work.

    The work was presented as a poster at the WIP 2014 Congress at Maastricht, the Netherlands, May 7 to 10, 2014.

    The authors declare no conflict of interest.

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