Korean J Pain.  2019 Oct;32(4):286-291. 10.3344/kjp.2019.32.4.286.

PECS II block is associated with lower incidence of chronic pain after breast surgery

  • 1Department of Medicine - DIMED, Section of Anesthesiology and Intensive Care, University of Padova, Padova, Italy. alessandro.decassai@gmail.com
  • 2Day Surgery Multidisciplinare, Surgical Department, Azienda Ospedaliera Padova, Padova, Italy.


Breast cancer is complicated by a high incidence of chronic postoperative pain (25%-60%). Regional anesthesia might play an important role in lowering the incidence of chronic pain; however it is not known if the pectoral nerve block (PECS block), which is commonly used for breast surgery, is able to prevent this complication. Our main objective was therefore to detect any association between the PECS block and chronic pain at 3, 6, 9, and 12 months in patients undergoing breast surgery.
We conducted a prospective, monocentric, observational study. We enrolled 140 consecutive patients undergoing breast surgery and divided them in patients receiving a PECS block and general anesthesia (PECS group) and patients receiving only general anesthesia (GA group). Then we considered both intraoperative variables (intravenous opioids administration), postoperative data (pain suffered by the patients during the first 24 postoperative hours and the need for additional analgesic administration) and development and persistence of chronic pain (at 3, 6, 9, and 12 mo).
The PECS group had a lower incidence of chronic pain at 3 months (14.9% vs. 31.8%, P = 0.039), needed less intraoperative opioids (fentanyl 1.61 μg/kg/hr vs. 3.3 μg/kg/hr, P < 0.001) and had less postoperative pain (3 vs. 4, P = 0.017).
The PECS block might play an important role in lowering incidence of chronic pain, but further studies are needed.


Analgesics, Opioid; Anesthesia, Local; Breast Neoplasm; Chronic Pain; Clinical Study; Humans; Nerve Block; Pain, Postoperative

MeSH Terms

Analgesics, Opioid
Anesthesia, Conduction
Anesthesia, General
Anesthesia, Local
Breast Neoplasms
Chronic Pain*
Clinical Study
Nerve Block
Observational Study
Pain, Postoperative
Prospective Studies
Thoracic Nerves
Analgesics, Opioid


  • Fig. 1 Study flowchart. PECS: pectoral nerve block.

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