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PECTORAL (PECSI & PECSII) BLOCKADE AND BLOCKADE OF CUTANEOUS BRANCHES OF THE INTERCOSTAL NERVES IN THE MID-AXILLARY LINE (BRILMA) FOR NON-RECONSTRUCTIVE BREAST SURGERY (NRBS)
Author(s): ,
Salazar Aguirre, J.C.*
Affiliations:
Hospital Universitario de Fuenlabrada, Anestesiología- Reanimación y Terapéutica del dolor, Madrid, Spain
,
Blanco Vazquez, G.
Affiliations:
Hospital Universitario de Fuenlabrada, Anestesiología- Reanimación y Terapéutica del dolor, Madrid, Spain
,
Oses Marcaida, A.
Affiliations:
Hospital Universitario de Fuenlabrada, Anestesiología- Reanimación y Terapéutica del dolor, Madrid, Spain
,
Bedmar Cruz, M.D.
Affiliations:
Hospital Universitario de Fuenlabrada, Anestesiología- Reanimación y Terapéutica del dolor, Madrid, Spain
Olarra Nuel, J.
Affiliations:
Hospital Universitario de Fuenlabrada, Anestesiología- Reanimación y Terapéutica del dolor, Madrid, Spain
ESRA Academy. Salazar Aguirre J. Sep 13, 2017; 190994
Topic: REGIONAL ANAESTHESIA TECHNIQUES - BLOCK PERFORMANCE
Dr. Jossy Carolina Salazar Aguirre
Dr. Jossy Carolina Salazar Aguirre

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Abstract
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Background and Aims:

Peripheral nerve blocks are currently being used to manage the pain for breast surgery. The main objective of this study is to compare the effectiveness of PECs and BRILMA blocks in the NRBS.

Methods:

An observational retrospective study in 22 patients who underwent NRBS under general anesthesia and ultrasound guided peripheral blockade was conducted. 9 patients were treated with PECs and 13 with BRILMA. To perform the blockade, 20 cc of levobupivacaine 0,5% were used. The blockade efficacy was assessed by numerical rating scale (NRS) 30 minutes after surgery and before discharge from recovery room (RR). Less than 3 is consider effective and ≥3 is consider ineffective. Furthermore, the need of rescue treatment and adverse effects (nausea/vomiting) were evaluated.  

Results:

PECs block showed an effective control (NRS <3) in 78%  of patients and ineffective control (NRS ≥3) in 22% of cases at 30 minutes. Before discharge the effectiveness was 89% and the ineffectiveness was 11%. The BRILMA block effectiveness at 30 minutes was 62% and 38% was ineffective. In this group, 69% of patients had an effective pain control and in 31% of the patients showed to be ineffective. The need of opioids was 18% in the PECs group and 23% in BRILMA group. The adverse effects were seen in 9% of all groups.

Conclusions:

We concluded that both blockades are effective. In this review the PECs block was superior to the BRILMA block in terms of pain control. There was no difference regarding adverse effects.

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