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ORIGINAL ARTICLE
Year : 2019  |  Volume : 63  |  Issue : 7  |  Page : 530-536

Is COMBIPECS the answer to perioperative analgesia for breast surgery? A double blinded randomized controlled trial


1 Department of Anaesthesiology, Critical Care and Pain, Tata Medical Center, Kolkata, West Bengal, India
2 Department of Breast Oncoplastic Surgery, Critical Care and Pain, Tata Medical Center, Kolkata, West Bengal, India

Correspondence Address:
Dr. Arunangshu Chakrborty
Department of Anaesthesiology, Critical Care and Pain, Tata Medical Center, 14 MAR (EW), Newtown, Kolkata -700 156, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_222_19

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Background and Aims: Pecs block and its variations provides perioperative analgesia, reduce PONV and other opioid related side effects. We hypothesized that COMIBPES block in addition to general anaesthesia will provide better postoperative analgesia when compared to general anaesthesia alone in breast cancer surgery patients. Methods: After obtaining permission from the institutional review board and registering the trial with Clinical Trials Registry of India(CTRI), we conducted a double blinded randomized controlled trial of 100patients posted for elective breast surgery with axillary dissection. Patients were divided into two groups, P(Pecs block) and C(control). Intraoperative analgesia, postoperative analgesia, postoperative nausea vomiting(PONV) and shoulder mobility on first postoperative day(POD1) were noted. Primary outcomes were the pain scores measured by visual analog scale(VAS) and cumulative intravenous morphine consumption from patient controlled analgesia(PCA) pump at measurement intervals of 0, 1, 4, 8, 12 and 24 hours postoperatively. Results: Intraoperatively, GroupP patients did not require any additional analgesia, whereas all the patients in GroupC required additional intraoperative morphine(mean, SD: 5.12, 2.63mg, compared to nil in groupP, P<0.01). COMBIPECS block group had lower pain scores and PCA morphine requirements, less PONV and better shoulder mobility on POD1. Conclusion: COMBIPECS block is a valuable addition to general anaesthesia for breast cancer surgery as it reduces pain and PONV while allowing better postoperative shoulder mobility.


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