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Regional Fascial Plane Blocks and Early Postoperative Complications in Reduction Mammaplasty: A Retrospective Cohort
Handan Derebaşınlıoğlu1, Onur Avcı2, Murat Çelik3
1Department of Plastic, Reconstructive and Aesthetic Surgery, Sivas Cumhuriyet University, 58070, Sivas, Turkey.
Background:
Regional fascial plane blocks are widely used in breast surgery for postoperative analgesia. While analgesic benefits are established, their impact on early complications after reduction mammaplasty remains unclear.
Objective:
To evaluate the association between regional fascial plane block use and early postoperative complications following superior pedicle reduction mammaplasty.
Methods:
This retrospective cohort study included 144 consecutive patients undergoing primary bilateral superior pedicle reduction mammaplasty at a single tertiary center. Patients were grouped as block (n=64) or no-block (n=80). All blocks were performed postoperatively at the end of surgery. The primary outcome was a 30-day composite complication, defined as hematoma requiring reoperation, wound dehiscence, or surgical site infection. Multivariable logistic regression assessed the independent association between block use and complications.
Results:
Overall, 55 patients (38.2%) developed at least one early postoperative complication. The composite complication rate was higher in the block group than in the no-block group (46.9% vs. 31.3%); however, this difference did not reach statistical significance (p=0.060). In multivariable analysis, block use was not independently associated with complications, whereas total excision weight was the only significant predictor. Hematomas occurred only in the block group (7.8% vs. 0%, p=0.016).
Conclusions:
Regional fascial plane block use was not independently associated with overall postoperative morbidity after adjustment. Although hematomas were observed only in the block group, the low event rate and non-randomized design preclude causal inference. However, a relevant increase in overall complication risk cannot be ruled out; therefore, further prospective studies are needed to clarify this relationship.
Level Of Evidence Iii:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .