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"This study shows that US-guided PECS-1 provides adequate analgesia following TIVAP insertion as part of multimodal analgesia. The PECS-1 significantly reduced opioid consumption" Pişkin et al (2021).

Implantable port insertion pain prevention

Abstract:

Background: The aim of this prospective, randomized, controlled study was to evaluate the analgesic effect of US-guided Pectoral (PECS) I blocks on postoperative analgesia after TIVAP insertion.

Methods: A hundred-twenty patients were included in this study. The patients were divided into two groups: Group PECS and Group INF (infiltration). A total 0.4 mL kg-1 0.25% bupivacaine was injected to below the middle of the clavicle in the interfascial space between the pectoralis major and minor muscles for PECS-1. The skin and deep tissue infiltration of the anterior chest wall was performed with 0.4 mL kg-1 0.25% bupivacaine for INF group. Tramadol and paracetamol consumption, visual analog scale pain scores were recorded at 0, 1, 4, 12, and 24 h postoperatively.

Results: The use of the PECS in TIVAP significantly decreased the amount of paracetamol used in the first 24 h postoperatively (p < 0.001). There was a statistically significant difference in the number of tramadol rescue analgesia administered between the groups (p < 0.001) There was no significant difference between the groups in terms of the VAS scores at 0 and 24 h. However, VAS scores at 1, 4, and 12 h were found to be significantly lower in patients who underwent PECS than in those who received infiltration anesthesia (p < 0.001).

Conclusions: This study shows that US-guided PECS-1 provides adequate analgesia following TIVAP insertion as part of multimodal analgesia. The PECS-1 significantly reduced opioid consumption.


Reference:

Pişkin Ö, Altınsoy B, Baytar Ç, Aydın BG, Okyay D, Küçükosman G, Bollucuoğlu K, Yılmaz AG, Ayoğlu H. The effect of PECS-1 block on postoperative pain in total implantable venous access port catheter (TIVAP) insertion. J Vasc Access. 2021 Jul 28:11297298211034615. doi: 10.1177/11297298211034615. Epub ahead of print. PMID: 34320865.