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Parasternal Intercostal Block Complementation Contributes to Postoperative Pain Relief in Modified Radical Mastectomy Employing Pectoral Nerve Block I and Serratus-Intercostal Block: A Randomized Trial

Authors Song WQ, Wang W, Yang YC, Sun Q, Chen H, Zhang L, Bu XS, Zhan LY, Xia ZY

Received 5 November 2019

Accepted for publication 18 February 2020

Published 30 April 2020 Volume 2020:13 Pages 865—871


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Michael Schatman

Wen-Qin Song, Wei Wang, Ying-Cong Yang, Qian Sun, Hui Chen, Lei Zhang, Xue-Shan Bu, Li-Ying Zhan, Zhong-Yuan Xia

Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China

Correspondence: Zhong-Yuan Xia; Liying Zhan
Department of Anesthesiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan City, Hubei Province 430060, People’s Republic of China

Purpose: Pectoral nerve block I (PECS I) and serratus-intercostal plane block (SIPB) can anesthetize the majority mammary region, while parasternal intercostal block (PSI) targets the internal area during breast resection surgery. The aim of this study was to determine whether including PSI with PECS I and SIPB is more effective compared to PECS I and SIPB alone.
Patients and Methods: Sixty-two adult females undergoing unilateral modified radical mastectomy (MRM) were randomly assigned to receive either PECS I and SIPB (PS group, n=31) or a combination of PECS I, SIPB, and PSI (PSP group, n=31). The outcomes were measured with a numerical rating scale (NRS) score, and in terms of opioid consumption and anesthesia-related complications within 48 h after surgery.
Results: Although there were no differences in the NRS scores between the two groups during the inactive periods, the combination of three nerve blocks significantly reduced the NRS scores during movement. In addition, morphine equivalent consumption was lower in the PSP group compared to the PS group. Postoperative adverse events were similar in both groups in terms of regional anesthesia-related complications.
Conclusion: The combination of PECS I block, SIPB, and PSI block provides superior pain relief and postoperative recovery for patients undergoing MRM.

Keywords: pectoral nerve block, serratus-intercostal plane block, parasternal intercostal block, postoperative analgesia, modified radical mastectomy

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