A double-blinded, randomized controlled trial was performed to investigate the efficacy of the pectoral nerve block for post-surgery analgesia in breast surgery subjects.

The study cohort incorporated 60 American Society of Anesthesiologists (ASA) grade I–II women undergoing unilateral modified radical mastectomy under general anesthesia. Participants were randomized into two groups: (i) PECS group (n = 29) was administered ipsilateral pectoral nerve block I & II (ii) Control group (n =29) directly proceeded to surgery. Comparing immediate post-surgery pain scores at movement and rest was the major endpoint.

The secondary endpoints were: (i) Post-surgery pain scores at 2, 4, 6, 12, 18, and 24 h, (ii) total intraoperative fentanyl intake, (iii) Post-surgery vomiting, nausea, and complications, and (iv) time to rescue analgesia. Utilizing the chi-squared test or Fishers Exact test, assessment of categorical data was done. Utilizing the independent sample t-test, the comparison of pain scores was done.

The immediate post-surgery pain scores in the two cohorts were comparable. Pain scores were found to be similar at 4, 6, 12, and 24 h; but considerably reduced in the PECS cohort at 2 and 18 h. In the PECS group, the total intraoperative fentanyl intake was also diminished. As found, only nine subjects in the PECS group (796.5 min) in comparison with 22 subjects in the control group (387.7 min) needed rescue analgesia.

Pectoral nerve block benefits individuals undergoing breast surgery by attaining similar postoperative pain scores with a lowered intake of post-operative and intraoperative opioids.