Ultrasound-Guided PECS II Block Reduces Periprocedural Pain in Cardiac Device Implantation: A Prospective Controlled...

Area of Science:

• Anesthesiology
• Cardiology
• Regional Anesthesia

Background:

• Cardiac implantable electronic device (CIED) implantation is common in elderly and comorbid patients.
• Minimizing perioperative pain and systemic drug use is crucial for this patient population.
• Conventional local infiltration often provides inadequate analgesia for CIED procedures.

Purpose of the Study:

• To evaluate the efficacy of the ultrasound-guided Pectoralis nerve block for Kedua (PECS) II block compared to standard local anesthesia.
• To assess pain reduction and analgesic requirements during and after CIED implantation.

Main Methods:

• A prospective, controlled, non-randomized study included 106 patients undergoing de novo CIED implantation.
• Patients received either a PECS II block (n=53) or standard lidocaine local anesthesia (n=53).
• Pain was assessed using the Numeric Rating Scale (NRS) intraoperatively and postoperatively at 1, 6, and 12 hours.

Main Results:

• The PECS II group reported significantly lower NRS pain scores at all measured time points (p < 0.001).
• Rescue analgesia was needed in only 7.5% of the PECS II group versus 100% of the control group within 1 hour.
• The PECS II block group showed reduced hospital stay, procedural duration, and higher patient satisfaction.

Conclusions:

• Ultrasound-guided PECS II block is an effective and safe alternative for perioperative pain management during CIED implantation.
• This regional anesthesia technique significantly reduces pain and the need for additional analgesia, sparing opioids.
• Integrating PECS II blocks into clinical protocols can improve patient comfort and recovery after CIED procedures.