Single injection pectoral nerve block (Pecs I and Pecs II) versus local anesthetic infiltration for ambulatory breast augmentation combined with monitored anesthesia care

Background: This randomized, double-blind study was designed to compare single injection pectoral nerve block (Pecs I and Pecs II) versus local anesthetic infiltration for ambulatory breast augmentation under monitored anesthesia care (MAC). Methods: In this randomized, double-blind, prospective study, 80 patients scheduled for breast augmentation under MAC using dexmedetomidine were divided into two groups. Pecs group: Ultrasound-guided pectoral nerve block was performed on both sides of the chest. Local anesthetic (LA) group: Local anesthetic infiltration was performed in the desired plane and skin incision site of each breast. The number of patients converted to general anesthesia was calculated. Postoperative pain intensity was measured using visual analog scale (VAS), and morphine consumption in the first 24 h and patient satisfaction were measured. Results: The success rate of the ultrasound-guided block versus local infiltration to complete surgery without conversion to general anesthesia was statistically non-significant. VAS, time of the first analgesia, and total morphine consumption were statistically significantly different between the two studied groups with significantly higher values in the LA group than Pecs group. Patient satisfaction was significantly higher in the Pecs group than in the LA group. Conclusion: The combination of Pecs blocks with MAC is helpful in patients undergoing breast augmentation.