Abstract：
Background: Pectoral nerve block (PECS) is increasingly performed in breast surgery. Aim: The study evaluated the clinical impact of these blocks in the postoperative course. Patients & methods: In this case-control study, patients undergoing breast surgery with \'enhanced recovery after surgery\' pathways were divided into group 1 (57 patients) in whom PECS was performed before general anesthesia, and group 2 (57 patients) in whom only general anesthesia was effected. Results: Postoperative opioid consumption (p < 0.002), pain at 32 h after surgery (p < 0.005) and the length of stay (p < 0.003) were significantly lower in group 1. Conclusion: Reducing opioid consumption and pain after surgery, PECS could favor a faster recovery with a reduction in length of stay, ensuring a higher turnover of patients undergoing breast surgery.
‘Enhanced recovery after surgery’ (ERAS) protocols have been recently applied in breast cancer patients in order to improve the postoperative course. However, the incidence of moderate to severe pain after breast surgery is frequent, and a multimodal approach is recommended. In this view, the interfascial plane blocks are advocated as a valid alternative to both paravertebral and epidural blockade. In this study, we evaluated the effects of these blocks on the postoperative course in patients undergoing breast surgery with ERAS protocols. We compared two patient groups: in the first, pectoral blocks were performed before general anesthesia, while in the second no block was carried out. We found that in the patient group receiving the blocks, postoperative opioid consumption (with essentially the same pain after surgery) and length of stay were significantly lower. Therefore, although more robust studies are needed to confirm our findings, these emerging locoregional techniques could favor a faster recovery in the context of ERAS in breast surgery. These results could have important clinical implications in terms of not only reducing healthcare costs but also ensuring a higher turnover of patients undergoing breast surgery.
‘Enhanced recovery after surgery’ (ERAS) protocols have been recently applied in breast cancer patients in order to improve the postoperative course. However, the incidence of moderate to severe pain after breast surgery is frequent, and a multimodal approach is recommended. In this view, the interfascial plane blocks are advocated as a valid alternative to both paravertebral and epidural blockade. In this study, we evaluated the effects of these blocks on the postoperative course in patients undergoing breast surgery with ERAS protocols. We compared two patient groups: in the first, pectoral blocks were performed before general anesthesia, while in the second no block was carried out. We found that in the patient group receiving the blocks, postoperative opioid consumption (with essentially the same pain after surgery) and length of stay were significantly lower. Therefore, although more robust studies are needed to confirm our findings, these emerging locoregional techniques could favor a faster recovery in the context of ERAS in breast surgery. These results could have important clinical implications in terms of not only reducing healthcare costs but also ensuring a higher turnover of patients undergoing breast surgery.
摘要：
背景：胸神经阻滞（PECS）在乳腺手术中越来越多地进行。目的：该研究评估了这些阻滞在术后过程中的临床影响。患者和方法：在这项病例对照研究中，将接受“术后加速恢复”途径的乳腺手术的患者分为第1组（57例），其中在全身麻醉前进行PECS，和第2组（57例）仅进行全身麻醉。结果：术后阿片类药物消耗（p<0.002），第1组术后32小时的疼痛(p<0.005)和住院时间(p<0.003)显著降低.结论：减少阿片类药物的消耗和术后疼痛，PECS可以通过减少停留时间来促进更快的恢复，确保接受乳房手术的患者更高的营业额。
最近在乳腺癌患者中应用了“术后增强恢复”（ERAS）方案，以改善术后病程。然而,乳腺手术后中重度疼痛发生率较高,建议采用多模式治疗.在这个观点中,筋膜平面阻滞被认为是椎旁阻滞和硬膜外阻滞的有效替代方法。在这项研究中,我们评估了这些阻滞对接受ERAS方案的乳房手术患者术后病程的影响.我们比较了两组患者：第一组，在全身麻醉前进行胸肌阻滞，而在第二个没有进行封锁。我们发现在接受区块的患者组中，术后阿片类药物用量(术后疼痛基本相同)和住院时间显著降低.因此,尽管需要更有力的研究来证实我们的发现，这些新兴的局部技术可能有利于在乳腺外科ERAS的背景下更快地恢复。这些结果可能具有重要的临床意义，不仅可以降低医疗保健成本，而且可以确保接受乳房手术的患者的更高更替率。
最近在乳腺癌患者中应用了“术后增强恢复”（ERAS）方案，以改善术后病程。然而,乳腺手术后中重度疼痛发生率较高,建议采用多模式治疗.在这个观点中,筋膜平面阻滞被认为是椎旁阻滞和硬膜外阻滞的有效替代方法。在这项研究中,我们评估了这些阻滞对接受ERAS方案的乳房手术患者术后病程的影响.我们比较了两组患者：第一组，在全身麻醉前进行胸肌阻滞，而在第二个没有进行封锁。我们发现在接受区块的患者组中，术后阿片类药物用量(术后疼痛基本相同)和住院时间显著降低.因此,尽管需要更有力的研究来证实我们的发现，这些新兴的局部技术可能有利于在乳腺外科ERAS的背景下更快地恢复。这些结果可能具有重要的临床意义，不仅可以降低医疗保健成本，而且可以确保接受乳房手术的患者的更高更替率。
