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PECS BLOCKS - ONE STEP CLOSER TO A DAY CASE BREAST CANCER SURGERY - CASE SERIES
ESRA Academy. Kurzatkowski K. Sep 8, 2016; 138312
Topic: Breast surgery
Dr. Krzysztof Kurzatkowski
Dr. Krzysztof Kurzatkowski

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Abstract
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Background and Aims:

An introduction of Pectoral Nerve Blocks (PECS) by Blanco offered simple yet effective regional technique to provide analgesia for breast procedures. Additionally they can facilitate early discharge by avoidance of opiates and their side effects, increasing the potential for day case surgery. This study presents an analysis of our initial experience using PECS blocks for routine breast cancer surgery.

Methods:

All female patients who underwent unilateral breast and axillary procedure between October and December 2015 were identified. Data related to the anaesthetic, surgery, and analgesia was recorded retrospectively using a standardised data-sheet. The PECS blocks were placed pre-operatively under ultrasound guidance with an in-plane approach and 18 gauge, 90 mm SonoTAP Tuohy at the level of 4th rib, using a total of 30 ml 0.25% l-bupivacaine.

Results:

Out of 32 patients included, 22 had local anaesthetic wound infiltration, and 10 received PECS Blocks. There were statistically significant reductions in both intra-operative (7.58 mg vs. 1.1 mg IV morphine, p=0.0007) and the total opiate use (10.6 mg vs. 3.3 mg IV morphine, p=0.01) when PECS blocks were used. There was a tendency towards significance in both the reduction of post-operative use of anti-emetics (0.9 standard doses/pt vs. 0.3 standard doses/pt, p=0.24) and the need for more than one type of antiemetic (23% vs 0%, p=0.15) with PECS blocks.

Conclusions:

The use of PECS II blocks reduced the amount of both opiate analgesics and anti-emetics, increasing the potential for day case surgery.

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