Comparation of pectoral block/propofol anaesthesia versus sevofluorane/fentanyl anaesthesia for breast cancer surgery


Background:  Breast cancer surgery is one of the most frequently performed surgeries. This include tumorectomies and mastectomies with axillary clearance when needed. Even relatively minor breast  surgery can be associated with significant postoperative pain. Thoracic epidural analgesia, paravertebral blocks and other regional techniques are commonly associated to general anaesthesia.Intercostal nerve block (PIB)  is another alternative described as particularly useful for ambulatory patients 
Goal of study: We aim to demostrate that PIB provides better postoperative analgesia than general anaesthesia with sevofluorane and opioids (SAO) with less nausea and vomiting (PONV) and better patient comfort.

Material & Methods: 20 women with diagnosis of breast cancer were randomized to recieve either PIB, with 20 ml chirocane 0.25% ,  performed under ultrasound guidance , or SAO anesthesia. Intraoperative fentanyl consumption, postoperative Visual analogic scale (VAS) pain scores at 1 and 24 h postoperative, postoperative fentanyle consumption, PONV scores and postsurgical hospital stay were recorded.
Resultados: Patient demographics and duration of surgery were comparable for both groups(Fig I). PIB group had no need of opioids in the recovery room and presented significantly lower VAS pain scores and less PONV scores.There was no difference in hospital stay or intraoperative fentanyl(Fig 2).
Discursion:Intercostal nerve block is easy  to perform and is associated to less adverse events then epidural o paravertebral block,

Postoperative analgesia requirements after propofol anaesthesia with intercostal nerve block versus sevofluorane and opioids for breast cancer surgery