Interfascial Plane Blocks Reduce Postoperative Pain and Morphine Consumption in Thoracic Outlet Decompression

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Pain Management

Background:

• Transaxillary thoracic outlet decompression (TATOD) surgery presents significant postoperative pain management challenges.
• Patients often require substantial opioid analgesia, leading to potential side effects.
• Novel regional anesthesia techniques are needed to improve pain control after TATOD.

Purpose of the Study:

• To compare the analgesic efficacy of two regional anesthesia techniques against a standard opioid regimen.
• To evaluate the combined pectoral block type 1 and erector spinae block (PECS 1 + ESB) and the pectoral block type 2 (PECS 2).
• To assess pain scores, opioid consumption, nausea, and vomiting in patients undergoing TATOD.

Main Methods:

• A retrospective study involving patients undergoing TATOD.
• Comparison of three groups: PECS 1 + ESB, PECS 2, and no block (systemic opioids only).
• Data collected on pain (numeric rating scale), opioid use, nausea, and vomiting.

Main Results:

• Both PECS 1 + ESB and PECS 2 groups showed significantly lower postoperative pain scores compared to the no-block group.
• Opioid consumption was reduced by 43% with PECS 1 + ESB and 56% with PECS 2.
• No statistically significant differences were observed in nausea or vomiting rates between the groups.

Conclusions:

• PECS 1 + ESB and PECS 2 blocks are effective in reducing postoperative pain after TATOD.
• These regional anesthesia techniques significantly decrease the need for systemic opioids.
• Regional anesthesia offers a promising alternative for managing pain in TATOD patients.