An assessment of the Pectoral Block Type I and II

Breast cancer is the most common female cancer comprising about 25% of all worldwide cases. Particularly in Belgium, breast cancer and its sequelae are a clinically significant problem. Belgium has both the highest incidence rate of female breast cancer as well as the highest rate of breast cancer survivors. The treatment of breast cancer is multidisciplinary and involves surgical –, radiation – and medical oncology treatment. For the majority of breast cancer cases, surgery is the primary and most effective therapeutic intervention. Even minimal breast surgery can result in significant acute pain and up to two thirds of female breast cancer surgery patients develop persistent pain and sensory disturbances in the months after treatment. This pain may impair women’s professional lives, sleep and other activities. Anesthesiologists have developed and introduced many strategies to manage pain during and after breast cancer surgery. These strategies include multimodal systemic analgesia and the introduction of regional anesthesia techniques such as the thoracic epidural or thoracic paravertebral block. However, there has not yet been a widespread clinical adoption of any regional anesthesia technique. The goal of this doctoral project has been to investigate the analgesic characteristics of a novel regional anesthesia technique in breast cancer surgery: the Pecs block. We concluded that the Pecs block is a easy and reliable technique that significantly improves the quality of analgesia and reduces opioid consumption following breast cancer surgery compared to systematic analgesia alone. Given that its analgesic efficacy is similar to that of a thoracic paravertebral blockade, the Pecs block warrants consideration as a first-line option for regional anesthesia in breast cancer surgery. To achieve an optimal effect, we recommend to aim the needle just medial of the thoraco-acromial artery and use a high volume injection.

Publication year:2019

Keywords:Doctoral thesis

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