Comparison of Analgesic Efficacy of Serratus Anterior Plane Block and Pectoral Nerve Block in Patients Undergoing Breast Surgery

Abstract

Objective: Breast surgery is usually associated with intense post-operative pain, which lead to chronic pain. We compared the analgesic efficacy of two ultrasound guided nerve blocks that is Pectoral nerve block (PECS) and Serratus anterior plane block (SAP) post operatively. Material and Methods: This double-blind, randomized study was done on 60 adult females, who were posted for breast surgery. General anesthesia was given with intravenous midazolam 1 mg, fentanyl 1.5 mcg/kg for premedication and then injection propofol 1–2 mg/kg and vecuronium 0.1 mg/kg. After this all patients received either ultrasound?guided PECS block at 3-4th rib Group 1 (n = 30) or SAP at 5th rib Group 2 (n = 30) with 0.375 % bupivacaine. Time when need of first rescue analgesia and tramadol consumption in 0,2,4,6,8,12,24 and 48h was noted. For pain assessment Visual analogue scale (VAS) scores and any adverse effect were recorded. Results: The mean duration of analgesia (mean ± Standard deviation [S.D.]) observed longer in the PECS group as compared to SAP group 21.6 hours v/s 23 hours (1380 ± 382 min v/s 1296 ± 232 min). The post?operative analgesic consumption was significantly higher in the SAP group (200mg) as compared to PECS group (133.3 mg)( P-value < 0.001). Conclusion: Ultrasound guided SAP block is a good analgesic alternative for breast surgery, although PECS block has a better analgesic profile than SAP block. Keywords - Breast surgery, Nerve block, Pectoral nerve block, Postoperative analgesia, Serratus anterior plane block