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Evaluation of Pectoral Nerve Block in Modified Radical Mastectomy: Comparison of Three Concentrations of Ropivacaine.
Clin Interv Aging. 2020; 15:937-944.CI

Abstract

Background

Pectoral nerve block type I (PECS I Block) and type II (PECS II Block) with ropivacaine are relatively new analgesic methods for breast-cancer surgery. We evaluated the safety and efficacy of different concentrations of ropivacaine given in the same volume for the PECS II Block in patients undergoing modified radical mastectomy (MRM).

Patients and Methods

One hundred and twenty women undergoing elective MRM who met inclusion criteria were divided randomly into four groups of 30: control group without PECS II Block and R0.2%, R0.3%, and R0.4% groups, who received general anesthesia plus the PECS II Block with ropivacaine at 0.2%, 0.3%, and 0.4%, respectively, in a volume of 40 mL.

Results

The postoperative numerical rating scale (NRS) pain score at rest and active was significantly higher in the control group than that in the three ropivacaine groups (P<0.05 for all), and the postoperative NRS score in the R0.3% group and R0.4% group at 12, 24, and 48 h postoperatively were significantly lower than that in the R0.2% group (P<0.05 for all); there was no significant difference between the R0.3% group and R0.4% group. The time when pain was first felt after MRM, the total number of complaints during 3, 6, 12, 24, and 48 h after MRM, and the total analgesic requirement (tramadol consumption) during the first 24 h postoperatively in the R0.3% group and R0.4% group were significantly lower than those in the control group and R0.2% group (P<0.05 for all); there was no significant difference between the R0.3% group and R0.4% group.

Conclusion

A dose of 0.3% ropivacaine was the optimal concentration for a PECS II Block for patients undergoing MRM because it provided efficacious analgesia during and >48 h after MRM. Increasing the ropivacaine concentration did not improve the analgesia of the PECS II Block significantly.

Authors+Show Affiliations

Department of Anesthesiology, The First Hospital of Jiaxing (Affiliated Hospital of Jiaxing University), Jiaxing, People's Republic of China.Department of Paediatrics, Affiliated Hospital of Guilin Medical University, Guilin, People's Republic of China.Department of Anesthesiology, Affiliated Hospital of Guilin Medical University, Guilin, People's Republic of China.

Pub Type(s)

Case Reports
Clinical Trial

Language

eng

PubMed ID

32606635

Citation

Deng, Wei, et al. "Evaluation of Pectoral Nerve Block in Modified Radical Mastectomy: Comparison of Three Concentrations of Ropivacaine." Clinical Interventions in Aging, vol. 15, 2020, pp. 937-944.
Deng W, Fu D, He L. Evaluation of Pectoral Nerve Block in Modified Radical Mastectomy: Comparison of Three Concentrations of Ropivacaine. Clin Interv Aging. 2020;15:937-944.
Deng, W., Fu, D., & He, L. (2020). Evaluation of Pectoral Nerve Block in Modified Radical Mastectomy: Comparison of Three Concentrations of Ropivacaine. Clinical Interventions in Aging, 15, 937-944. https://doi.org/10.2147/CIA.S251613
Deng W, Fu D, He L. Evaluation of Pectoral Nerve Block in Modified Radical Mastectomy: Comparison of Three Concentrations of Ropivacaine. Clin Interv Aging. 2020;15:937-944. PubMed PMID: 32606635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of Pectoral Nerve Block in Modified Radical Mastectomy: Comparison of Three Concentrations of Ropivacaine. AU - Deng,Wei, AU - Fu,Dan, AU - He,Liang, Y1 - 2020/06/22/ PY - 2020/02/27/received PY - 2020/05/29/accepted PY - 2020/7/2/entrez PY - 2020/7/2/pubmed PY - 2020/7/2/medline KW - modified radical mastectomy KW - pectoral nerve block KW - postoperative analgesia SP - 937 EP - 944 JF - Clinical interventions in aging JO - Clin Interv Aging VL - 15 N2 - Background: Pectoral nerve block type I (PECS I Block) and type II (PECS II Block) with ropivacaine are relatively new analgesic methods for breast-cancer surgery. We evaluated the safety and efficacy of different concentrations of ropivacaine given in the same volume for the PECS II Block in patients undergoing modified radical mastectomy (MRM). Patients and Methods: One hundred and twenty women undergoing elective MRM who met inclusion criteria were divided randomly into four groups of 30: control group without PECS II Block and R0.2%, R0.3%, and R0.4% groups, who received general anesthesia plus the PECS II Block with ropivacaine at 0.2%, 0.3%, and 0.4%, respectively, in a volume of 40 mL. Results: The postoperative numerical rating scale (NRS) pain score at rest and active was significantly higher in the control group than that in the three ropivacaine groups (P<0.05 for all), and the postoperative NRS score in the R0.3% group and R0.4% group at 12, 24, and 48 h postoperatively were significantly lower than that in the R0.2% group (P<0.05 for all); there was no significant difference between the R0.3% group and R0.4% group. The time when pain was first felt after MRM, the total number of complaints during 3, 6, 12, 24, and 48 h after MRM, and the total analgesic requirement (tramadol consumption) during the first 24 h postoperatively in the R0.3% group and R0.4% group were significantly lower than those in the control group and R0.2% group (P<0.05 for all); there was no significant difference between the R0.3% group and R0.4% group. Conclusion: A dose of 0.3% ropivacaine was the optimal concentration for a PECS II Block for patients undergoing MRM because it provided efficacious analgesia during and >48 h after MRM. Increasing the ropivacaine concentration did not improve the analgesia of the PECS II Block significantly. SN - 1178-1998 UR - https://www.unboundmedicine.com/medline/citation/32606635/Evaluation_of_Pectoral_Nerve_Block_in_Modified_Radical_Mastectomy:_Comparison_of_Three_Concentrations_of_Ropivacaine L2 - https://dx.doi.org/10.2147/CIA.S251613 DB - PRIME DP - Unbound Medicine ER -
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