SAN FRANCISCO – Women undergoing mastectomy for breast cancer experience improved postsurgical pain relief and reduced opioid consumption when given a pectoralis nerve plane (PECS) block prior to surgery, suggests research presented at the ANESTHESIOLOGY® 2018 annual meeting
. The PECS block is a newer regional anesthesia technique that works by injecting long-acting anesthetics, guided by ultrasound, to numb the front of the chest wall before surgical incision.
“Physician anesthesiologists are reassessing pain management strategies due to the ongoing opioid crisis,” said Jon Y. Zhou, M.D., assistant clinical professor at the University of California School of Medicine, Davis Medical Center, Sacramento, California. “Perioperative ‘opioid sparing’ techniques that limit opioid consumption during and after surgery are among the ways we can help curb the opioid epidemic. Our study found women who received a PECS block prior to surgery had significantly less total opioid consumption, from the start of surgery to the first day after surgery, compared to patients who did not receive the block.”
Breast cancer is one of the most common cancers affecting women, with an incidence of 1 in 8 women in the United States. Mastectomy is often performed for treatment of breast cancer; however, many patients experience severe acute postsurgical pain. The acute pain is typically treated with opioids, which have many side effects including nausea, constipation, sleepiness, respiratory depression, and can eventually lead to dependence and addiction. Mastectomy patients are also at high risk of developing chronic pain (pain lasting three months or more), which can impair quality of life. Any perioperative interventions performed by physician anesthesiologists to reduce acute pain after surgery, including the use of regional anesthesia and opioid sparing techniques, have the potential to decrease the risk of chronic post-mastectomy pain, the researchers note.
In the study, researchers examined 152 patients who had unilateral or bilateral mastectomy between 2012 and 2017. Ninety-eight patients received a PECS block prior to general anesthesia, while 54 patients received general anesthesia only. Opioid consumption was collected at multiple time points – during surgery, in the post-anesthesia care unit (PACU) and on the first day after surgery.
THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.
For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Join the ANESTHESIOLOGY® 2018 social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter and use the hashtag #ANES18.