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Abstract
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Background and Aims Aesthetic breast surgery is the most common body surgery. Aim is that the procedure itself from induction of anaesthesia to early and late recovery, enables a quick return to daily activities and work.
Methods 136 patients divided into two groups underwent breast augmentation in general analgesia.The control group had surgically infiltrated interfascial pectoral nerve block performed through a small puncture incision in the axillary region with application of 5 ml 0,5% Bupivacaine per side to the pectoral muscle region between large and small pectoral muscles.The comparative group had general anaesthesia.Intensity of pain was analysed the first 7 days using NRS.Ethics committee approved.
Results The greatest progress in reducing pain is observed on the first and second day after surgery, while on day 3 the pain is present minimally more than in previous days. The slight pressure is felt after 5 days in both groups. All patients were able to return to daily activities and work after 7 days postoperatively while avoiding carrying heavier loads and strenuous physical activities.
Conclusions The pectoral nerve block with Bupivacaine deposited in the layer containing the pectoral nerves between the pectoralis major and pectoralis major muscles decreased pain scores approximately 50% lower than controls during the first 24 postoperative hours decreasing opioid requirements.There were reduction of nausea, vomiting and sedation in the recovery room. Discharge was earlier as well. If future research confirms the effectiveness of these blocks, they could be considered a standard for breast surgery because of their ease of application and relatively low potential of complications.
Pectoral nerves analgesia
Local infiltration of the wound
Inframammary incision, LA injection site