The aim: to compare the efficacy of pectoral nerve block type II and thoracic paravertebral block for analgesia during and after breast cancer surgery.
Materials and methods: Sixty adult women were undergoing unilateral radical mastectomy or quadrantectomy with axillary dissection. Patients were randomized to receive
either pectoral nerve block with ropivacaine 0.375% 30 ml or thoracic paravertebral block with ropivacaine 0.5% 20 ml. Evaluated variables included pain intensity at 0, 2, 4, 6,
12, 18 and 24 hours, intraoperative fentanyl, 24-hour postoperative opioid (promedol) and nonopioid (ketoprofen) consumption, the time to first rescue analgesia.
Results: There were no statistically significant differences between pectoral block and paravertebral block groups in intraoperative fentanyl consumption 2,2 (1,81-2,81) vs 1,9
(1,63-2,25) mcg/kg/hour (Р>0,05) and in the pain intensity during the first 24 hours after operation. The mean postoperative 24-hour promedol and ketoprofen consumption
was 4,0 (±8,14) mg vs 5,0 (±8,85) mg (Р>0,05) and 66,7 (±66,09) mg vs 95,8 (±90,78) mg (Р>0,05) in the pectoral and paravertebral block groups respectively. Time to the
first analgesia request was longer in pectoral block group — 540 (455,0-600,0) min vs 515 (265,0-650,0) min (Р>0,05). There were no complications after pectoral blocks and
2 complications after paravertebral blocks.
Conclusions: in breast cancer surgery pectoral nerve block type II can provide postoperative analgesia comparable to thoracic paravertebral block with lower complications rate.
Pectoral nerve block combined with general anesthesia for breast cancer surgery: a retrospective comparison
