Background and aims USG PECS I and II blocks are relatively new interfascial plane blocks and are gaining popularity in breast surgery. They have been shown to reduce postoperative pain and opioid consumption compared to GA alone1,2 and when combined with continuous local anaesthetic (LA) infusion.3 However, literature comparing PECS block to local anaesthetic wound infiltration is limited.
Our retrospective study compares USG PECS block versus surgeon administered LA wound infiltration (WI) in terms of postoperative analgesia, antiemetic usage, time spent in anaesthetic room and complications.
Methods All patients undergoing wide local excision and breast biopsy from 03/05/18 to 19/10/18 were included. Data was collected from anaesthetic charts and electronic prescriptions. Primary outcomes were 24-hour postoperative analgesia consumption, antiemetic consumption and time spent in the anaesthetic room.
Results 27 patients were included in our study; 7 patients received USG PECS block and 20 patients received WI by surgeons. Within the PECS group, 3 patients received PECS II, 3 patients received both PECS I&II and 1 patient received PECS I block (table 1). Both groups received similar total doses of LA.
Conclusions We found no significant difference in analgesia usage between the two groups. More patients required antiemetic post-surgery in the PECS block group. There was no difference in time spent in the anaesthetic room between the two groups. No complications were reported in either group. Further randomised controlled trials are needed to investigate the mooted benefits of PECS block and explore local anaesthetic WI as a potentially effective and safe alternative to PECS block.
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