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PECS II block for cardiac implantable electronic device insertion: A pilot study.

Mustafa Kilin1, Ali Sait Kavakli2, Arzu Karaveli1

  • 1Department of Anesthesiology and Reanimation, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey.

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|September 4, 2023
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Summary

The Pectoral Nerve (PECS) II block offers effective postoperative pain relief for cardiac implantable electronic device (CIED) insertion for at least 24 hours. While not always providing complete anesthesia alone, it aids a smoother procedure when supplemented.

Keywords:
Cardiac implantable electronic deviceanalgesiaanesthesiaintraoperativepectoral nerves blockpostoperative

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Area of Science:

  • Regional Anesthesia
  • Pain Management
  • Cardiovascular Procedures

Background:

  • Truncal blocks can offer anesthesia and analgesia for cardiac implantable electronic device (CIED) insertion.
  • Evaluating novel blocks is crucial for optimizing patient care during CIED procedures.

Purpose of the Study:

  • To assess the feasibility of the Pectoral Nerve (PECS) II block for CIED insertion.
  • To determine the efficacy of PECS II block in providing surgical anesthesia and postoperative analgesia.

Main Methods:

  • Ultrasound-guided PECS II blocks were performed on 30 patients undergoing CIED insertion.
  • Feasibility was measured by the need for additional local anesthesia during surgery.
  • Secondary outcomes included pain scores, analgesic consumption, and patient satisfaction.

Main Results:

  • 63.3% of patients required additional local anesthesia during surgery.
  • 86.6% of patients reported high satisfaction with the procedure.
  • Postoperative pain was effectively managed for at least 24 hours, with minimal opioid use.

Conclusions:

  • The PECS II block provides effective postoperative analgesia for at least 24 hours after CIED insertion.
  • While not always sufficient for complete anesthesia, PECS II block, when supplemented, contributes to a smooth intraoperative course.
  • PECS II block is a viable option for managing pain associated with CIED procedures.