Background and Aims This study aimed at investigating the efficacy of PECS Blocks in alleviating symptoms in the immediate post-operative period and in reducing the occurrence of chronic pain following surgical treatment for breast cancer

Methods We enrolled 64 women who were randomized to the performance or not of PECS blocks. Evaluation of pain was based on the numerical pain rating scale (NRS) ranging from 0 to 10. In addition, the required supplemental morphine dose in the immediate post-operative period was compared between the two groups. All patients were evaluated at 3 and 6 months after surgery using the DN4 questionnaire for neuropathic pain

Results The incidence of postmastectomy pain syndrome (DN4≥4) in the PECS group was 28.1% at 3 months and 3.1% at 6 months, while in the non-PECS group it was 46.9% at 3 months and 28.1% at 6 months, with the difference between the groups being statistically significant at 6 months (p=0.016). The NRS values at three different time points (immediately postoperatively, at 12 and 24 hours) were higher in the non-PECS group compared with the PECS group and this difference was statistically significant at all three time points (p<0.001). Significant differences were found in supplemental morphine doses after discharge from PACU and for 24 hours, with the PECS group requiring 1.5 ± 2.48 mg and the non-PECS group requiring nearly four times more (p < 0.01)

Conclusions The peri-operative use of PECS blocks reduced acute postoperative pain, diminished postoperative morphine requirements and lowered the risk of development of chronic pain

Ethics Committee Approval