An Observational Analysis about Novel Chest Wall Blocks (PECS and SERRATUS) During Breast Surgery

Introduction: Nowadays breast surgery is one of the common surgical procedure associate with moderate and severe sequences in term of postoperative pain. Recently new chest wall blocks emerged and appear an optimal solution to decrease acute postoperative pain onset with its chronicization. Materials and Methods: Five Italian Hospitals participated to an observational study. Women submitted to breast surgery performed with the use of chest wall blocks were enrolled to the study. We analyzed the postoperative pain onset in the first 48 hours, the perioperative complications, the perioperative opioids use and postoperative nausea and vomiting rate. Results: Our multicenter observational analysis yielded 279 women that performed breast surgery addicted with a chest wall blocks in a period of six month. The procedures analyzed were Ductectomy, Lymphadenectomy, and Mastectomy with lymphadenectomy, Mastoplasty, Nodulectomy, Breast plastic, Quadrantectomy with SLNB (Sentinel Lymph Node Biopsy), Quadrantectomy with SLNB and lymphadenectomy. Mastectomy with lymphadenectomy registered the worse postoperative pain at 6 postoperative hours (3 (1,25- 4,75[0-8])). The postoperative rescue opioids use was encountered mainly after mastoplasty (16,6%) and lymphadenectomy (16,6%). Postoperative nausea and vomiting rate was 5,01% (all procedures together). None blocks were related to complications, only 2 women referred a motility alteration on surgical side arm with spontaneous resolution. Discussion and Conclusion: The use of such innovative techniques allows obtaining analgesia of type long-lasting, in the absence of PONV and major complications, reducing, postoperatively, the additional demand for analgesics and antiemetic. Further randomized studies are necessary to confirm our analysis.