Does Pecs II Block Reduce the Incidence of Post Mastectomy Pain Syndrome (PMPS)? A Cross Sectional Study

ABSTRACT Background and Objectives Post mastectomy pain syndrome (PMPS) is a chronic pain condition that develops after breast cancer surgery. The objective of this study was to determine if Pecs II block administered prior to general anesthesia (GA) reduced the incidence of PMPS after mastectomy and axillary clearance (MAC) when compared with conventional analgesic therapy. Methods This cross sectional study compared incidence and severity of PMPS in 288 women who underwent unilateral MAC. Questionnaire survey was done via personal and telephone interview with 145 patients who received conventional analgesic therapy versus 143 patients who received Pecs II block. Outcomes assessed included incidence, severity and chronic pain symptom and sign score of PMPS. Results We found a significantly lower incidence of PMPS in patients who received Pecs II block compared with conventional analgesic therapy [49.7% vs. 63.4%, OR 0.57 (0.36-0.91), P = 0.018], which was a 22% relative risk reduction (RR 0.78). Severity of PMPS in Pecs II group was also significantly reduced as shown by lower static and dynamic pain scores at operative site ( P < 0.001). Furthermore, Pecs II group reported significantly lower Chronic Pain Symptom and Sign Score ( P = 0.002) compared to conventional group. Conclusions Pecs II block prior to MAC significantly reduced the incidence of PMPS, severity of chronic pain at operative site and number of chronic pain symptoms and signs related to PMPS. This study is registered under National Medical Research Register. NMRR ID: 17-2627-38056