Breast Lumpectomy Surgery by Pectoral Nerve Block (Pecs Block) without General Anesthesia – A Case Report

Penulis

  • Ida Bagus Reza Nanda Iswara Department of Anesthesiology & Pain Medicine, Wangaya Hospital, Denpasar
  • Wayan Widana Department of Anesthesiology & Pain Medicine, Wangaya Hospital, Denpasar

DOI:

https://doi.org/10.56951/medicinus.v34i1.58

Kata Kunci:

breast lumpectomy, surgery, Pectoral Nerve Block, Anesthesia

Abstrak

Breast conserving surgery is usually performed under general anesthesia, or more recently combined with regional anesthesia techniques. Thoracic spinal block, thoracic epidural block, and thoracic paravertebral block are options of regional anesthesia that have been used in breast surgery, but anesthesiologists avoid them due to concern in potency of complications and side effects. After introduced by Blanco in 2011, pectoral nerves (Pecs) block appears as alternative procedure with fewer complications and lower incident of postoperative pain.

In this case report, we describe a 32-year-old female patient admitted for elective lumpectomy of the left upper quadrant of the breast. Ultrasound guided Pecs II block was chosen as the anesthetic technique for this patient.

The authors reported successful management of anesthesia and pain without complications in breast surgery. Pecs II block as single anesthetic technique can be considered safe, advantageous, and effective in breast surgery with good hemodynamic stability and few side effects.

Referensi

Gonzales J. PECS versus PVBS for Perioperative Analgesic Management in Breast Surgery. American Society of Regional and Pain Medicine 2016;16(3):41-4.

Blanco R. The “Pecs Block” : A Novel Technique For Providing Analgesia After Breast Surgery. Anaesthesia 2011;66(9):847-8. DOI: https://doi.org/10.1111/j.1365-2044.2011.06838.x

Blanco R, Fajardo M, Maldonado TP. Ultrasound description of Pecs II (modified Pecs I): a novel approach to breast surgery. Rev Esp Anestesiol Reanim 2012;59(9):470-5. DOI: https://doi.org/10.1016/j.redar.2012.07.003

Blanco R, Barrington J. Pectoral and Serratus Plane Blocks. Hadzic’s textbook of Regional Anesthesia and Acute Pain Management. The New York of Regional Anaesthesia 2017;35:650-60.

Bashandy GMN, Abbas DN. Pectoral Nerves I and II Blocks in Multimodal Analgesia for Breast Cancer Surgery: A Randomized Clinical Trial. Regional Anesthesia and Pain Medicine 2015; 40(1):68-74 DOI: https://doi.org/10.1097/AAP.0000000000000163

Senapathi TGA, Widnyana IMG, Aribawa IGNM, Jaya AAGPS, Junaedi IMD. Combined ultrasound-guided Pecs block and general anesthesia are effective for reducing pain from modified radical mastectomy. Journal of Pain Research 2019;12:1353-8. DOI: https://doi.org/10.2147/JPR.S197669

Hakim KYK, Wahba Z. Single injection pectoral nerve block (Pecs I and Pecs II) versus local anesthetic infiltration for ambulatory breast augmentation combined with monitored anesthesia care. Ain-Shams Journal of Anesthesiology 2019;11(18):1-7. DOI: https://doi.org/10.1186/s42077-019-0033-y

Eldeen HMS. Ultrasound guided pectoral nerve blockade versus thoracic spinal blockade for conservative breast surgery in cancer breast: A randomized control trial. Egyptian Journal of Anaesthesia 2016;32(1):29-35. DOI: https://doi.org/10.1016/j.egja.2015.08.005

Wahba SS. Kamal SM. Thoracic paravertebral block versus pectoral nerve block for analgesia after breast surgery. Egyptian Journal of Anaesthesia 2014;30:129-35. DOI: https://doi.org/10.1016/j.egja.2013.10.006

Diterbitkan

01-04-2021

Unduhan

Data unduhan tidak tersedia.

Cara Mengutip

[1]
Breast Lumpectomy Surgery by Pectoral Nerve Block (Pecs Block) without General Anesthesia – A Case Report. MEDICINUS 2021;34:33-6. https://doi.org/10.56951/medicinus.v34i1.58.