Pectoral nerve block1 versus modified pectoral nerve block2 for postoperative pain relief in patients undergoing modified radical mastectomy: a randomized.

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Presentation transcript:

Pectoral nerve block1 versus modified pectoral nerve block2 for postoperative pain relief in patients undergoing modified radical mastectomy: a randomized clinical trial† S. Goswami, P. Kundra, J. Bhattacharyya British Journal of Anaesthesia Volume 119, Issue 4, Pages 830-835 (October 2017) DOI: 10.1093/bja/aex201 Copyright © 2017 The Author(s) Terms and Conditions

Fig 1 Consort flow chart. Group PEC1: general anaesthesia and PEC1, Group mPEC2: general anaesthesia and mPEC2. British Journal of Anaesthesia 2017 119, 830-835DOI: (10.1093/bja/aex201) Copyright © 2017 The Author(s) Terms and Conditions

Fig 2 Epidural catheter being positioned between muscle planes after surgery under direct vision before wound closure. (A) PEC1 Block (Catheter placed between pectoralis major and pectoralis minor). (B) mPEC2 Block (Catheter placed between pectoralis minor and serratus anterior). British Journal of Anaesthesia 2017 119, 830-835DOI: (10.1093/bja/aex201) Copyright © 2017 The Author(s) Terms and Conditions

Fig 3 Mean VAS (SEM) over time in both the groups. VAS=Visual Analogue Scale, SEM=Standard error of mean. Area under curve for Group mPEC2 [9.77 (6.93)] [mean(SEM)]. Area under curve for Group PEC1 [24.19 (10.81)] [mean(SEM)]. *P<0.05. British Journal of Anaesthesia 2017 119, 830-835DOI: (10.1093/bja/aex201) Copyright © 2017 The Author(s) Terms and Conditions

Fig 4 Pattern of spread and staining of structures after injection of bupivacaine and methylene blue mixture in PEC1 and mPEC2 block. (A) Figure shows the pattern of spread and staining in PEC1 block. The axillary folds are spared. Area of lateral pectoral nerve is not stained. Thoracodorsal nerve which is more lateral is partially stained. (B) Figure shows the pattern of spread and staining in mPEC2 block. Axilla is well stained with the dye as it has ascended up. (C) Figure shows the pattern of spread and staining in mPEC2 block. Area of lateral pectoral nerve and thoracodorsal nerve are well stained. P. minor=Pectrolis minor, LPN=Lateral pectoral nerve, TDN= Thoracodorsal nerve, LTN=Long thoracic nerve. British Journal of Anaesthesia 2017 119, 830-835DOI: (10.1093/bja/aex201) Copyright © 2017 The Author(s) Terms and Conditions