Opioid-Sparing Pain Management Following Mastectomy

Perioperative Regional Anesthesia Technique Produces Better Patient Outcomes

An innovative regional anesthesia technique administered before surgery may result in better pain relief and reduced opioid consumption in women undergoing mastectomy for breast cancer. The pectoralis nerve plane (PECS) block is an ultrasound-guided method of delivering long-acting anesthetics to the front of the chest prior to surgery. John Zhou, MD, assistant clinical professor at the University of California School of Medicine, Davis Medical Center, Sacramento, commented, “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.”

Severe acute postsurgical pain is a common condition in women treated for breast cancer by mastectomy, and these patients are at increased risk for developing chronic pain and diminished quality of life. Opioids given post-operatively are a typical treatment modality, but there has been significant interest in the development of opioid-sparing alternatives. In this study, 152 patients who underwent unilateral or bilateral mastectomy were categorized to receive a PECS block before general anesthesia (98 subjects) or general anesthesia alone (54 subjects). Researchers noted opioid consumption at several points during and after surgery and found a statistically significant reduction among the PECS recipients both during surgery and 1 day postprocedure. The findings were presented at the ANESTHESIOLOGY® 2018 annual meeting.

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