Related Experiment Video
Updated: Nov 28, 2025
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Pectoral nerve blocks for breast surgery: A meta-analysis
Michael Meißner1, Ece Austenfeld, Peter Kranke
1From the Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Muenster, Albert-Schweitzer-Campus 1, Muenster (MM, EA, EMP-Z, AS), Department of Anaesthesia and Critical Care, University Hospital of Wuerzburg, Wuerzburg (PK, SW) and Department of Anaesthesiology, Intensive Care Medicine and Pain Medicine, BG-Universitätsklinikum Bergmannsheil gGmbH, Medical Faculty of Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, Bochum, Germany (PKZ, CHM-F).
Pectoral nerve blocks (PECS block) may reduce postoperative pain at rest for breast surgery patients compared to no treatment. However, evidence quality is moderate, and more research is needed for other comparisons.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Pain Management
Background:
- Pectoral nerve blocks (PECS block) represent a potential regional anesthetic technique for breast surgery.
- Postoperative pain management is crucial for patients undergoing breast surgery.
Purpose of the Study:
- To conduct a meta-analysis evaluating the efficacy of PECS blocks in managing postoperative pain after breast surgery.
- To compare PECS blocks against no treatment, sham treatment, and other regional anesthetic techniques.
- To assess adverse events associated with PECS blocks.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched databases including MEDLINE, CENTRAL, and clinicaltrials.gov.
- Included RCTs comparing PECS blocks with sham, no treatment, or other regional techniques in women undergoing breast surgery under general anesthesia.
Main Results:
- PECS block showed moderate quality evidence for reducing pain at rest compared to no treatment (MD -1.14, 95% CI -2.1 to -0.18).
- Uncertainty exists regarding PECS block's effect on pain during movement and at rest compared to sham or paravertebral blocks (PVB), with very low-quality evidence.
- Block-related complications were poorly reported.
Conclusions:
- Moderate quality evidence suggests PECS blocks reduce postoperative pain at rest compared to no treatment.
- PECS blocks may be as effective as paravertebral blocks (PVBs).
- Further research is warranted due to the predominantly low or very low quality of evidence.
