The Effect of Pectoral Nerves Blocks on Narcotic Consumption and Pain Intensity in the Patients Undergoing Breast Cancer Surgery

Background: To decrease postoperative pain (PP) control, opioid requirement, and outcome improvement, regional anesthesia or preoperative analgesia is routinely performed as an alternative to general anesthesia. Thoracic wall nerve blocks, such as the pectoral nerves (PECS) block have recently become popular for preoperative pain control in patients undergoing breast cancer (BC) surgery. Objectives: The current study was designed to evaluate the effect of PECS anesthesia on the fentanyl and propofol consumption, as well as time to the first request to analgesia in the patients with BC surgery. Methods: A total of 22 women aged 20 to 75 years old with biopsy-proven BC were randomized to receive either propofol general anesthesia with PECS or total intravenous anesthesia without PECS in a randomized clinical trial. Total propofol and fentanyl dose and time to the first request for postoperative analgesia were assessed and compared in both groups. Results: The obtained data showed no significant difference in the total dose of fentanyl and propofol between the two groups. However, the PECS group showed a significant increase in time to the first request for postoperative analgesia. Conclusions: The PECS block in combination with general anesthesia for BC surgery significantly increased time to the first request to analgesia and was effective for reducing PP in the recovery room. PECS block combined with general anesthesia did not reduce the intraoperative use of fentanyl and propofol compared with the control group injected with normal saline.