ArticleJournal of anaesthesiology, clinical pharmacology
Opioid-free anesthesia for breast cancer surgery: A comparison of ultrasound guided paravertebral and pectoral nerve blocks. A randomized controlled trial.
Article in Journal of anaesthesiology, clinical pharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Regional analgesia techniques for postoperative pain after breast cancer surgery: a network meta-analysis.The Cochrane database of systematic reviews · 2025Pooled it
- Efficacy of regional anesthesia techniques for postoperative analgesia in patients undergoing major oncologic breast surgeries: a systematic review and network meta-analysis of randomized controlled trials.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2022Pooled it
- Comparison of Pectoral Nerve and Paravertebral Blocks for Postoperative Pain Management in Breast Surgery: A Multicentre Randomised Double-Blind Trial.Journal of breast cancer · 2025Article
- Opioid-Free Anesthesia Versus Opioid-Balanced Anesthesia in Breast Surgeries: A Randomized Study.Cureus · 2025Article
- Opioid-Free Anesthesia for Upper Limb Surgery in Obese Patients as a Day Case Surgery: A Prospective Observational Study.Anesthesiology and pain medicine · 2024Article
- Enhanced Recovery After Aesthetic Breast Surgery Under Sedation, Intercostal Block and Tumescent Anaesthesia: A Prospective Cohort Study of the Early Postoperative Phase.Aesthetic plastic surgery · 2023Article
- The Use of Pectoralis Blocks in Breast Surgery: A Practice Advisory and Narrative Review from the Society for Ambulatory Anesthesia (SAMBA).Annals of surgical oncology · 2022Review
- Postoperative Nausea and Vomiting in Female Patients Undergoing Breast and Gynecological Surgery: A Narrative Review of Risk Factors and Prophylaxis.Frontiers in medicine · 2022Review
- Post-operative pain following cardiac implantable electronic device implantation: insights from the BRUISE CONTROL trials.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2021Article
- Comparison of analgesic effects and postoperative cognitive function following total knee arthroplasty: continuous intravenous infusion of fentanyl vs. ultrasound-guided continuous femoral nerve block with ropivacaine.American journal of translational research · 2021Article
- Practical Review of Abdominal and Breast Regional Analgesia for Plastic Surgeons: Evidence and Techniques.Plastic and reconstructive surgery. Global open · 2020Review
- Antiproliferative effect of bupivacaine on patient-derived sarcoma cells.Molecular and clinical oncology · 2020Article
- Regional anesthesia in breast surgery: An Italian expert consensus - Part 2: Results from a network meta-analysis evaluating 103 randomized controlled trials on regional anesthesia techniques for mastectomy with or without axillary clearance.Saudi journal of anaesthesiaArticle
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsPectoral block (PECS)-based anesthesia without opioids decreases analgesic requirement, pain scores and post-operative nausea vomiting (PONV) compared to conventional opioid-based general anesthesia in patients undergoing modified radical mastectomy and axillary dissection (MRM-AD). We compared PECS versus Paravertebral Block (PVB) in providing an opioid free, nerve block-based regimen. Outcomes of interest were post-operative analgesic requirement, duration of analgesia, PONV and patient and surgeon satisfaction. MATERIAL AND
methodsThis randomised controlled study involved 58 adult ASA I-III patients posted for MRM-AD. After randomization patients were induced with propofol and maintained on spontaneous ventilation with isoflurane (0.8-1.0 MAC) through i-gel. Ultrasound-guided PECS or PV blocks (30 ml of 0.1% lignocaine + 0.25% bupivacaine + 1 μg/kg dexmedetomidine) were administered. Post-operative pain scores, non-opioid analgesic requirement over 24 hours, PONV, satisfaction of surgeon and patient were measured.
resultsBetween the two groups, there was no difference in demographics, ASA status, location and volume of breast tumour excised or the duration of surgery. The time from block to incision was significantly longer in the PV group (
conclusionBoth blocks result in equally prolonged analgesia and preclude requirement of opioid analgesics intra and post-operatively. PECS block is associated with lesser time to allow incision. Complications are low in both the groups. Routine use of these blocks to avoid opioids may be studied further.
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