Research Article

Efficacy of Ropivacaine in Ultrasound Guided Pectoralis Nerve Block 2 versus Serratus Anterior Plane Block for Post Operative Analgesia in Breast Surgeries: A Prospective, Comparative Study

Abstract

Background: Breast surgeries can be associated with acute postoperative pain which if left untreated might lead to chronic pain therefore pre-emptive treatment post surgery can be favourable. The aim of our study was to evaluate the analgesic efficacy of PECS 2 compared to SAB to reduce post operative pain in breast surgeries done under general anaesthesia.
Methods: A total of 50 patients belonging to ASA 1 & 2 undergoing elective breast surgery were randomly assigned into two groups. Pectoralis nerve block 2 group received 25ml of 0.5% Ropivacaine and Serratus anterior plane block group received 25ml of 0.5% Ropivacaine under ultrasound guidance post induction. The primary outcome was to compare the duration of post operative analgesia with PECS 2 and SAB. Other outcome parameters observed were total rescue analgesic requirement, change in post operative hemodynamic parameters and complications if any.
Results: There was a significant difference in duration of post operative analgesia between two groups with Mean Duration of post operative Analgesia in PECS 2 being 510±32.6mins and SAB being 316±26.5mins (p=0.036). The VAS score as well as number of rescue analgesic requirement with PECS 2 was lesser when compared to SAB.
Conclusion: Ropivacaine in ultrasound guided PECS 2 block provided superior analgesic profile when compared to SAB.

[1] Blanco R. The ‘pecs block’: a novel technique for providing analgesia after breast surgery: Correspondence. Anaesthesia. 2011; 66(9):847–8.
[2] Chin KJ, Versyck B, Pawa A. Ultrasound‐guided fascial plane blocks of the chest wall: a state‐of‐the‐art review. Anaesthesia. 2021; 76:110-26.
[3] Chin KJ, Versyck B, Elsharkawy H, Gomez MF, Sala-Blanch X, Reina MA. Anatomical basis of fascial plane blocks. Reg Anesth Pain Med. 2021; 46(7):581-99.
[4] Kuthiala G, Chaudhary G. Ropivacaine: A review of its pharmacology and clinical use. Indian J Anaesth. 2011; 55(2):104-10.
[5] McClellan KJ, Faulds D. Ropivacaine: an update of its use in regional anaesthesia. Drugs. 2000; 60:1065-93.
[6] Razek AA, AbouAllo MM, Abd El Hamid SA, Osman MD. Ultrasound-guided pectoral nerve blocks versus serratus intercostal plane block in breast surgeries. Research and Opinion in Anesthesia and Intensive Care. 2018; 5(3):162.
[7] Kubodera K, Fujii T, Akane A, Aoki W, Sekiguchi A, Iwata K, et al. Efficacy of pectoral nerve block type-2 (Pecs II block) versus serratus plane block for postoperative analgesia in breast cancer surgery: a retrospective study. Nagoya J Med Sci. 2020; 82(1):93-9.
[8] Fujii T, Shibata Y, Akane A, Aoki W, Sekiguchi A, Takahashi K, et al. A randomised controlled trial of pectoral nerve‐2 (PECS 2) block vs. serratus plane block for chronic pain after mastectomy. Anaesthesia. 2019; 74(12):1558-62.
[9] Bakeer A, Abdallah NM. Erector Spinae Plane Block Versus PECS Block Type II for Breast Surgery: A Randomized Controlled Trial. Anesth Pain Med. 2022; 12(2).
[10] Arora S, Ovung R, Bharti N, Yaddanapudi S, Singh G. Efficacy of serratus anterior plane block versus thoracic paravertebral block for postoperative analgesia after breast cancer surgery-a randomized trial. Brazilian Journal of Anesthesiology. 2022; 72:587-92.
[11] Bakeer AH, Kamel KM, Abdelgalil AS, Ghoneim AA, Abouel Soud AH, Hassan ME. Modified pectoral nerve block versus serratus block for analgesia following modified radical mastectomy: a randomized controlled trial. J Pain Res. 2020; 13:1769-75.
Files
IssueArticle in Press QRcode
SectionResearch Article(s)
Keywords
Ropivacaine Pectoralis nerve block Serratus anterior plane Block Ultrasound

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Sheshadri K, Ramegowda S, Chandra M, Srinivasan R, Balakrishnaiah M, Kumar S. Efficacy of Ropivacaine in Ultrasound Guided Pectoralis Nerve Block 2 versus Serratus Anterior Plane Block for Post Operative Analgesia in Breast Surgeries: A Prospective, Comparative Study. Arch Anesth & Crit Care. 2024;.