Purpose: Combined regional and
general anesthesia are often used for the management of
breast cancer surgery. Thoracic spinal block, thoracic epidural block, thoracic paravertebral block, and multiple intercostal nerve blocks are the
regional anesthesia techniques which have been used in breast surgery, but some anesthesiologists are not comfortable because of the complication and side effects. In 2012, Blanco et al introduced pectoralis nerve (Pecs) II block or modified Pecs block as a novel approach to breast surgery. This study aims to determine the effectiveness of combined ultrasound-guided Pecs II block and
general anesthesia for reducing intra- and
postoperative pain from
modified radical mastectomy. Patients and methods: Fifty patients undergoing
modified radical mastectomy with
general anesthesia were divided into two groups randomly (n=25), to either Pecs (P) group or control (C) group. Ultrasound-guided Pecs II block was done with 0.25%
bupivacaine (P group) or
0.9% NaCl (C group).
Patient-controlled analgesia was used to control
postoperative pain. Intraoperative
opioid consumption, postoperative visual analog scale (VAS) score, and postoperative
opioid consumption were measured. Results: Intraoperative
opioid consumption was significantly lower in P group (P≤0.05). VAS score at 3, 6, 12, and 24 hrs postoperative were significantly lower in P group (P≤0.05). Twenty-four hours postoperative
opioid consumption was significantly lower in P group (P≤0.05). There are no complications following Pecs block in both groups, including
pneumothorax, vascular
puncture, and
hematoma. Conclusion: Combined ultrasound-guided Pecs II block and
general anesthesia are effective in reducing
pain both intra- and postoperatively in patients undergoing
modified radical mastectomy. Ultrasound-guided Pecs II block is a relatively safe peripheral nerve block.