Evaluating the pectoralis nerve blocks I & II for mastectomy patients at an academic hospital: A prospective observational cohort study.

Pablo Samuel Tshiteta; Lunganga Toms Lushiku; Mathabe Sehlapelo

doi:10.51168/g6tky576

Autori

Pablo Samuel Tshiteta Department of Anaesthesia, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand
Lunganga Toms Lushiku Department of Anaesthesia, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand
Mathabe Sehlapelo Senior Specialist, Department of Anaesthesiology at the University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, RSA.

DOI:

https://doi.org/10.51168/g6tky576

Cuvinte cheie:

breast cancer, chronic pain, mastectomy, pain, pectoralis nerve block, surgical drain, bupivacaine

Rezumat

Background:

Poorly managed perioperative mastectomy pain increases the incidence of chronic pain. The aim of this study was to compare PEC I & II blocks versus the administration of local anaesthesia (LA) via a surgical drain in female patients presenting for unilateral mastectomy. These techniques were compared with regard to postoperative pain scores, satisfaction, time to first request for systemic opioids postoperatively, opioid consumption, the incidence of postoperative nausea and vomiting (PONV), and complications.

Methods:

A prospective, cohort, observational, single-centre study with 33 female participants who were recruited via purposive sampling; three were excluded from the study. Participants were assigned to PEC blocks (Group P, n=15) or LA via surgical drain (Group S, n=15). Group S received the standard of care, which was administration of 2mg/kg of 0.5% bupivacaine with adrenaline (1:200,000) via the surgical drain. Group P received 0.2ml/kg of 0.5% bupivacaine plus adrenaline (1:200,000) in each fascial plane.

Results:

There were no significant differences in participants’ characteristics in the groups. The study showed no statistically significant difference between the pain scores of the groups at 30 minutes, 3, 6, and 24 hours postoperatively (p=0.660, p=0.160, p=0.894, p=0.931). The differences in patient satisfaction scores and morphine consumption were statistically insignificant. No complications were noted in either of the groups. No statistically significant relationship with the occurrence of vomiting and nausea and the specific technique.

Conclusion:

This study showed no difference between PEC I & II blocks and the administration of LA via a surgical drain in the management of postoperative pain in mastectomy patients. The techniques can be considered safe, as there was a low incidence of the described complications, including the incidence of PONV.

Recommendations:

The author recommends further research in the form of randomised controlled trials with larger sample sizes comparing all breast regional modalities.

Biografii autori

Pablo Samuel Tshiteta, Department of Anaesthesia, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand

is a dedicated anaesthesiologist with a strong passion for perioperative medicine, critical care, and advanced anaesthesia techniques. He graduated from the University of the Witwatersrand with a Master of Medicine in Anaesthesia (MMed Anaes). His professional interests include regional anaesthesia, target-controlled infusion (TCI), and critical care medicine, with a focus on improving patient safety, comfort, and outcomes through evidence-based practice and innovation. Dr. Tshiteta is committed to clinical excellence, continuous learning, and the mentorship of future healthcare professionals. His work combines academic knowledge with practical application, contributing to high-quality patient care, multidisciplinary collaboration, and the advancement of anaesthesia practice.
Lunganga Toms Lushiku, Department of Anaesthesia, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand

is a fellow of the Anaesthetic College of South Africa. He holds a master’s degree in Anaesthesia from the University of Wits. Currently practicing anaesthesia in the private sector in Johannesburg. His domains of interest are regional, paediatric and cardiothoracic anaesthesia.
Mathabe Sehlapelo, Senior Specialist, Department of Anaesthesiology at the University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, RSA.

is a senior anaesthesiologist at Chris Hani Baragwanath Academic Hospital and Lecturer in the Department of Anaesthesiology, University of the Witwatersrand, Johannesburg, South Africa. She is the domain head of airway management, breast and endocrine. She is committed to health sciences education through innovative pedagogy, student mentorship, health system management and community engagement.

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