J B Schuitemaker R1, X Sala-Blanch2, A P Sánchez Cohen3, L A López-Pantaleon4, J T Mayoral R4, M Cubero5. 1. Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, QuironSalud Hospital Universitari General de Catalunya e Hypnos S.L.P., Sant Cugat del Vallès, Barcelona, España. Electronic address: juanbernardosr@iCloud.com. 2. Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic de Barcelona, Departamento de Anatomía Humana, Universitat de Barcelona, Barcelona, España. 3. Servicio de Radiología Intervencionista, Invenciones Tecnológicas en Medicina (INTEM), QuironSalud Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Barcelona, España. 4. Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, QuironSalud Hospital Universitari General de Catalunya e Hypnos S.L.P., Sant Cugat del Vallès, Barcelona, España. 5. Sección de Estadística, Facultad de Biología, Universitat de Barcelona, Barcelona, España.
Abstract
INTRODUCTION:Prosthetic breast surgery is a very common plastic surgery procedure, but its postoperative analgesic management is a challenge for the surgical team. The purpose of the present study is to validate the analgesic efficacy of pectoral block and serratus plane block in retropectoral mammoplasty. PATIENTS AND METHODS: A randomised, controlled, triple-blind, clinical trial was designed, and included 30 patients undergoing retropectoral augmentation mammoplasty. All of them had a modified PECII block and a serratus plane block with a total volume of 40ml per breast. In 15 of them bupivacaine 0.25% (GPEC) was injected and in the other 15 patients saline was used (GC). Standardised management of anaesthesia and postoperative analgesia was performed. Intra-operative haemodynamic parameters required for postoperative analgesia, and a numeric verbal scale on arrival in the recovery unit were measured and at 3, 6, and 24h. The quality perceived by patients and surgeons was also measured. RESULTS:Post-operative pain was significantly better in GPEC (5.3±2.3 vs. 2.9±2.7; P=.018). No significant differences were observed at 3, 6, and 24h. The surgeons rated the anaesthetic-analgesic quality as very good in 80% of the cases in GPEC versus 33% in CG (P=.01). CONCLUSIONS: The use of these blocks is a good perioperative analgesic strategy in the multimodal management of retropectoral augmentation mammoplasty.
RCT Entities:
INTRODUCTION: Prosthetic breast surgery is a very common plastic surgery procedure, but its postoperative analgesic management is a challenge for the surgical team. The purpose of the present study is to validate the analgesic efficacy of pectoral block and serratus plane block in retropectoral mammoplasty. PATIENTS AND METHODS: A randomised, controlled, triple-blind, clinical trial was designed, and included 30 patients undergoing retropectoral augmentation mammoplasty. All of them had a modified PECII block and a serratus plane block with a total volume of 40ml per breast. In 15 of them bupivacaine 0.25% (GPEC) was injected and in the other 15 patientssaline was used (GC). Standardised management of anaesthesia and postoperative analgesia was performed. Intra-operative haemodynamic parameters required for postoperative analgesia, and a numeric verbal scale on arrival in the recovery unit were measured and at 3, 6, and 24h. The quality perceived by patients and surgeons was also measured. RESULTS: Post-operative pain was significantly better in GPEC (5.3±2.3 vs. 2.9±2.7; P=.018). No significant differences were observed at 3, 6, and 24h. The surgeons rated the anaesthetic-analgesic quality as very good in 80% of the cases in GPEC versus 33% in CG (P=.01). CONCLUSIONS: The use of these blocks is a good perioperative analgesic strategy in the multimodal management of retropectoral augmentation mammoplasty.
Authors: Pasquale Sansone; Luca Gregorio Giaccari; Mario Faenza; Pasquale Di Costanzo; Sara Izzo; Caterina Aurilio; Francesco Coppolino; Maria Beatrice Passavanti; Vincenzo Pota; Maria Caterina Pace Journal: BMC Anesthesiol Date: 2020-11-23 Impact factor: 2.217