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PECS BLOCK FOR MASTECTOMY: DOES IT MAKE A DIFFERENCE TO HOSPITAL STAY? A RETROSPECTIVE STUDY AT A DISTRICT GENERAL HOSPITAL
ESRA Academy. Pakkar-Hull A. Sep 8, 2016; 138327
Topic: REGIONAL ANAESTHESIA (RA) TECHNIQUES - CLINICAL IMPLICATIONS
Dr. Anoob Pakkar-Hull
Dr. Anoob Pakkar-Hull

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Abstract
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Background and Aims:

Pectoral nerve (PECS) blocks have been shown to provide superior immediate postoperative analgesia following mastectomy. Limited evidence is available evaluating the impact this can have on extended pain relief and length of stay (LOS).


A retrospective analysis of 35 mastectomies over a 6-month period with particular emphasis on pain scores and LOS was performed. Comparisons were made between those  receiving a preoperative PECS block versus no block. 

Methods:

Local R&D approval allowed all 35 patients data to be analysed from integrated electronic theatre and ward records. Pain scores were recorded at 0,6, and 24h at rest and during movement. A two-tailed Fisher’s Exact Test evaluated significance.

Results:

Eleven (31%) patients had a PECS block. The PECS cohort had more pain free patients during rest at 0h, 6h and 24h (81%, 81%, 73%) compared to no blocks (50%, 13%, 29%) [p=0.14, 0.0001, 0.02]. Assessing pain during movement revealed that at both 6h and 24h the PECS cohort had 55% patients pain free compared to 8% and 17% without block [p=0.0013, 0.04]. None of the PECS block patients had a pain score >5 out of 10 at any time compared to 58% of patients who received no block [p=0.04]. Median LOS for the PECS cohort was 1 day (two were discharged on day 0) compared to 2 days for no block.

Conclusions:

PECS blocks caused signifiant reduction in postoperative pain for mastectomy patients both during rest and movement even up to 24h. This may have led to a faster discharge from hospital.

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