Pectoral Nerve Blocks for Breast Augmentation Surgery: A Randomized, Double-blind, Dual-centered Controlled Trial

Area of Science:

• Anesthesiology
• Pain Management
• Plastic Surgery

Background:

• Pectoral nerve blocks are explored for breast surgery analgesia, but evidence in aesthetic procedures is conflicting.
• This study investigated the efficacy of pectoral nerve blocks for pain control following breast augmentation.

Purpose of the Study:

• To determine if preincisional pectoral nerve blocks improve pain control compared to standard multimodal analgesia alone after breast augmentation.
• To assess the impact of pectoral nerve blocks on reducing rescue opioid consumption and its duration.

Main Methods:

• A randomized trial involving 73 adult female patients undergoing aesthetic breast augmentation.
• Patients were allocated to receive either a pectoral nerve block or no block, alongside standard multimodal analgesia.
• Pain scores (Numerical Rating Scale), opioid consumption, and side effects were monitored post-extubation up to day 5.

Main Results:

• The pectoral nerve block group reported significantly lower maximal pain scores in the first 6 hours post-extubation (3.9 vs. 5.2, P=0.036).
• Lower pain scores were also observed between postoperative days 1 and 5 (2.2 vs. 3.2, P=0.032).
• Opioid consumption was substantially reduced in the pectoral nerve block group from hour 6 to day 5 (P=0.006 and P=0.002, respectively).

Conclusions:

• Pectoral nerve blocks, combined with multimodal analgesia, provide effective perioperative pain relief for aesthetic breast surgery.
• This approach significantly decreases opioid requirements in the initial 5 days after surgery.