INTERPECTORAL ANESTHETIC BLOCK (PEC) IN RADICAL MASTECTOMIES WITH AXILLARY APPROACH: AN ALTERNATIVE TO PAIN CONTROL IN AN ONCOLOGY SURGERY SERVICE IN MACEIÓ

Introduction: Patients undergoing mastectomies with axillary dissection suffer greatly from postoperative pain and discomfort, so sought to study regional blockade techniques that could minimize such effect, such as Interpectoral block (PEC). This innovative technique can become an analgesic option widely used in axillary surgery due to the low complication rate and the single puncture characteristic technique that allows simultaneous blockade of various dermatomes, reducing postoperative pain and The abusive use of opioids and their complications. Objectives: To disclose the anesthetic blockade technique performed in an oncologic surgery service, in order to expose alternatives for postoperative pain control in mastectomy patients. Method: PEC blockade performed after general anesthesia induced with fentanyl and Propofol and in maintenance with Sevoflurane and Remifentanil in infusion pump. Ultrasoundguided technique with injection of levobupivacaine with vasoconstrictor in the concentration of 0.37%, with infiltration of 10ml between pectoral muscles and 20ml between the pectoral minor and the sawdust muscle, followed by the surgical incision. All patients are evaluated in the postoperative period by the pain scale and receive prescription of dipyrone and/or tramadol, administered if necessary to not mask the level of pain. Results: The main study showing that the PEC blockade reduces postoperative pain after mastectomies with axillary approach, minimizing the use of opioids and their complications, was published by Blanco in 2011. In 2018 it was implanted in this referral service in oncological surgery of Maceió with good postoperative response and evidence of better satisfaction of patients with pain control after analysis of the EVA scale available postoperatively. Conclusion: The pectoral block technique (PEC) is easy to perform and feasible with better pain control of patients in the postoperative period of radical mastectomies with axillary approach.

Publication History

Article published online:
23 October 2019