A Randomized Single-Blinded Study Comparing Preoperative with Post-Mastectomy PECS Block for Post-operative Pain...

Area of Science:

• Anesthesiology
• Surgical Oncology
• Pain Management

Background:

• Ultrasound-guided pectoralis blocks (PECS I/II) are established for post-mastectomy pain.
• Optimal timing for PECS blocks remains unclear.
• This study compares pre-incision versus post-mastectomy block timing.

Purpose of the Study:

• To compare postoperative pain control and recovery outcomes.
• To determine if pre-incision or post-mastectomy PECS block timing is superior.
• To evaluate secondary outcomes including narcotic use and length of stay.

Main Methods:

• Randomized controlled trial comparing pre-incision (PreM) vs. post-mastectomy (PostM) PECS I/II blocks.
• Primary outcome: average pain score in PACU and inpatient stay.
• Secondary outcomes: pain scores at various time points, pain catastrophizing, narcotic use, length of stay, and complications.

Main Results:

• No significant differences in average pain scores between PreM and PostM groups.
• Similar pain scores at rest and during movement at multiple postoperative time points.
• No significant differences in block procedure time, length of stay, narcotic requirements, or complications.

Conclusions:

• Intraoperative ultrasound-guided PECS I/II blocks administered by surgeons post-mastectomy show comparable outcomes to preoperative blocks.
• Timing of PECS block (pre-incision vs. post-mastectomy) does not significantly impact pain control or recovery.
• Findings suggest flexibility in PECS block administration timing for mastectomy patients.