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Research article

Pectoral Nerve I and II Blocks, Single Versus Double Path, as an Effective Pain Management Strategy in Female Breast Cancer Surgery

Authors:

Hoda Shokri ,

Ain Shams University, Cairo, EG
About Hoda
Associate Professor of Anesthesiology
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Heba F. Abd El Aziz

Ain Shams University, Cairo, EG
About Heba
Lecturer of Anesthesiology
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Abstract

Excruciating pain is a common complication following breast surgery which can be effectively treated with double path PECS I and II blocks. Sixty patients undergoing breast surgery were randomly assigned into two groups: Single-path (SP) group received a single-path pectoral nerve (PECS) I and II block, by injecting 0.25% bupivacaine 15 ml into the space between the serratus muscle and the pectoralis minor muscle, then withdrawing the needle to inject equivalent dose of bupivacaine in the plane between the pectoralis muscles. Double path group (DP) received double path block; bupivacaine 0.25% 15 ml injected into the space between pectoralis muscles through one puncture and a similar dose of bupivacaine was injected into the potential space between pectoralis minor muscle and serratus muscle through another puncture. Performance time of technique, the onset and length of the sensory block, visual analogue pain ratings (VAS), satisfaction scores, postoperative analgesic requirements and success rate were the outcomes. Single-path block had a faster performance time. Pain scores were similar at all time periods, except for 10 hours postoperatively, where double-path group had lower pain scores. In the double path block, the onset was faster and sensory block lasted longer. Double-path injection group had higher satisfaction levels. The use of double-path pectoral blocks was a beneficial approach, as it was associated with a faster onset, higher satisfaction levels, and a longer duration of analgesia.
How to Cite: Shokri, H. and Abd El Aziz, H.F., 2022. Pectoral Nerve I and II Blocks, Single Versus Double Path, as an Effective Pain Management Strategy in Female Breast Cancer Surgery. Sri Lankan Journal of Anaesthesiology, 30(1), pp.52–58. DOI: http://doi.org/10.4038/slja.v30i1.8877
Published on 11 Jun 2022.
Peer Reviewed

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