Pectoral Nerves I, II and Serratus Plane Blocks in Multimodal Analgesia for Mastectomy: A Randomised Clinical Trial

Objective: To primarily assess pain score in first 24 hours in PECS (PECtoral Serratus) block group undergoing mastectomy; secondary objective was to observe opioid and antiemetic consumption in the postoperative period. Study Design: Observer-blinded randomised control trial. Place and Duration of Study: Department of Anesthesiology, Shaukat Khanum Memorial Cancer Hospital Lahore (SKMCH), from February to December 2017. Methodology: One hundred and twenty patients of more than 18 years, ASA I and II, planned for unilateral elective modified radical mastectomy under general anesthesia, were scheduled randomly to receive either general anesthesia plus PECS block (n = 60) or general anesthesia alone (n = 60). Pain scores at fixed intervals were measured using Numeric Pain Rating Score (NPRS) after the surgery. Results: Pain score in the PECS block group was significantly lower than the control group in postoperative period. Less dose of morphine was required in the PECS block group postoperatively for pain control. Postoperative nausea and vomiting (PONV) incidence was lower in the intervention group (PECS block) as compared with the control group. Conclusion: PECS block has a better analgesic efficacy in patients undergoing mastectomy.