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Abstract
Background and Aims In 2020, 11.7% of cancers diagnosed were female breast cancers, making it the most common cancer worldwide(1). With alarming incidence, surgery remains the main modality of management of resectable breast cancer. Despite the PROSPECT(2) guidelines, the regional anaesthetic
/analgesic practices for breast surgery vary greatly. This survey aims to determine the current regional anaesthetic/analgesic practices for oncological breast surgery across several centres of the UK.
Methods 60 anaesthetists from the Association of Breast Surgery(3) database of hospitals across the UK were emailed survey (Microsoft) forms, in order to ascertain their regional anaesthetic/analgesic practices for oncological breast surgery. The choice of regional block (if performed), its timing and the follow-up practices were determined.
Survey of the use of regional anaesthesia/analgesia for oncological breast surgery
The timing of the regional block (if used) for oncological breast surgery
The choice of the various regional techniques for oncological breast surgery
Results A 40% response to the survey was received, of which 62% responded positively to the use of regional blocks. 66% of anaesthestists preferred blocks post, rather than pre-induction (12%) or at the end of surgery (12%). Follow up of patients for persistent post-surgical pain is not being done at present in any of the centres surveyed. The pectoral nerve block (PECs I/II) and thoracic paravertebral blocks (PVB) were the preferred choices of blocks, with PECs I/II overtaking PVB for most breast surgeries. Serratus anterior plane (SAP) and Erector spinae plane block (ESP) are yet to gain their popularity, and axillary clearance has limited regional options at present.
Conclusions Though supplementing a regional technique over GA alone, for oncological breast surgery has a well-established advantage(4), further work in the field will help identify the barriers in its execution.