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Thoracic fascial planes blocks in operative bed of modified radical mastectomy and their role in alleviating post-mastectomy pain: a prospective randomized study

Internatioonal Surgery Joournal • 2022
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Publication Information
Authors Mohamed F. Abdelhalim*, Mohamed A. Elbegawy
Keywords Modified radical mastectomy, Fascial planes blocks, Nerve blocks, Pain control, Postmastectomy pain, PECS I and II blocks
Journal Internatioonal Surgery Joournal
Publisher Internnational surgery Journal
Volume 9
Issue 1
Pages 6-11
publication.type International
Paper Link Not Available
Supplementary Materials Not Available
Abstract
Background: Proper pain management after modified radical mastectomy is crucial for improving postoperative
outcomes, reducing tumor recurrence, enhancing anti-metastatic activity and achieving excellent patient`s satisfaction.
Thoracic fascial planes (TFP) blocks are novel, and safe analgesia modalities to control postmastectomy pain. This
study was designed to assess the efficacy and safety of intraoperative TFP blocks for providing postoperative
analgesia after modified radical mastectomy.
Methods: During the period from March 2020 to April 2021, 30 females (ages 25–67 years) were scheduled for
elective MRM and selected randomly to one of two groups; group-A included 15 patients who underwent MRM and
anesthetized with both general anesthesia and regional anesthesia (TFP blocks), group-B included 15 patients who
underwent MRM and anesthetized with only general anesthesia.
Results: The group-A had statistically significantly lower pain scores. The time of first rescue nalbuphine dose post operatively was statistically significantly longer in group-A compared to group-B. The total 24h nalbuphine
consumption and postoperative non-steroidal ketorolac requirements/48h were significantly lower in group-A
compared to group-B. Satisfaction score in group-A was statistically significantly better than that in group-B.
Conclusions: Intraoperative thoracic fascial planes blocks are simple, safe, and highly effective analgesic modalities
after breast surgery.