Original Scientific Report
Benefits of PECS Block as Part of the Enhanced Recovery After Surgery (ERAS) Protocol for Breast Cancer Surgery in an Asian Institution: A Retrospective Cohort Study
Kavinya Diana,
Mei-Sze Teh,
Tania Islam,
Woon-Lai Lim,
Zhi-Yuan Beh,
Nur Aishah Mohd Taib,
Kavinya Diana
Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorCorresponding Author
Mei-Sze Teh
Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorTania Islam
Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorWoon-Lai Lim
Department of Anaestesiology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorZhi-Yuan Beh
Department of Anaestesiology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorCorresponding Author
Nur Aishah Mohd Taib
Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorKavinya Diana,
Mei-Sze Teh,
Tania Islam,
Woon-Lai Lim,
Zhi-Yuan Beh,
Nur Aishah Mohd Taib,
Kavinya Diana
Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorCorresponding Author
Mei-Sze Teh
Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorTania Islam
Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorWoon-Lai Lim
Department of Anaestesiology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorZhi-Yuan Beh
Department of Anaestesiology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorCorresponding Author
Nur Aishah Mohd Taib
Department of Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia
Search for more papers by this authorCopyright comment: Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
Abstract
Introduction
Regional analgesia techniques have been increasingly used for post-operative pain management following mastectomy. We aim to evaluate analgesic benefits of pectoral nerve (PECS2) block incorporated as part of the enhanced recovery after surgery (ERAS) protocol in patients undergoing mastectomy in University Malaya Medical Centre, Malaysia.
Material and methods
A single centre, cohort study evaluating 335 women who have undergone unilateral mastectomy between January 2017 and March 2020 in Malaysia. Regional anaesthesia were given pre-operatively via ultrasound guided pectoral and intercostal nerves block (PECSII).
Results
Utilization of regional anaesthesia increased from 11% in 2017 to 43% in 2020. Types and duration of surgeries were comparable. Opiod consumption was 3 mg lower in those who had PECS2 block ((27 [24–30] mg), in comparison with those who received general anaesthesia only (30 [26–34] mg), p < 0.001, and length of stay was half a day shorter in the regional anaesthesia group and these were statistically significant. However, pain score (2 [1–3]; 2 [1–3], p=0.719) and post-operative nausea and vomiting (PONV) (32.6–32.5%, p = 0.996) were similar.
Conclusion
This study highlights the importance of PECS2 block as a component of ERAS protocol for mastectomy in an Asian hospital. This study also inferred that patients may be safely discharged within 24 h of surgery and therefore, same day surgery may be feasible in selected group of patients undergoing mastectomy and this could imply overall cost benefits.
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