ABSTRACT

Introduction Proper postoperative pain management in breast surgeries reduces complications, improves patient comfort, and decreases opioid use. Pectoralis nerve (PECS) blocks I and II are effective peripheral analgesic techniques in this context, promoting hemodynamic stability and faster recovery. The present article reviews the literature on PECS block efficacy in breast surgery analgesia and its relationship with reduced opioid use.
Materials and Methods We performed a systematic search in the PubMed database using the keywords breast surgery, pectoral nerve block, and opioid use. We included clinical trials published from January 2016 to April 2023 in Portuguese, English, and Spanish on the effects of PECS blocks I and II in breast surgeries, with a focus on pain control, opioid use, antiemetic requirements, length of hospital stay, and associated complications. We selected 14 articles after applying the eligibility criteria.
Results The PECS blocks demonstrated superior postoperative analgesia and reduced opioid use compared to general anesthesia or other interfascial blocks. They also resulted in lower rescue analgesia requirements and fewer complications.
Conclusion The PECS blocks are an effective strategy for postoperative pain management in breast surgeries, reducing opioid use and its adverse effects, while promoting better patient recovery.

Keywords: analgesia; breast; opioid analgesics; pain; postoperative pain

RESUMO

Introduction Proper postoperative pain management in breast surgeries reduces complications, improves patient comfort, and decreases opioid use. Pectoralis nerve (PECS) blocks I and II are effective peripheral analgesic techniques in this context, promoting hemodynamic stability and faster recovery. The present article reviews the literature on PECS block efficacy in breast surgery analgesia and its relationship with reduced opioid use.
Materials and Methods We performed a systematic search in the PubMed database using the keywords breast surgery, pectoral nerve block, and opioid use. We included clinical trials published from January 2016 to April 2023 in Portuguese, English, and Spanish on the effects of PECS blocks I and II in breast surgeries, with a focus on pain control, opioid use, antiemetic requirements, length of hospital stay, and associated complications. We selected 14 articles after applying the eligibility criteria.
Results The PECS blocks demonstrated superior postoperative analgesia and reduced opioid use compared to general anesthesia or other interfascial blocks. They also resulted in lower rescue analgesia requirements and fewer complications.
Conclusion The PECS blocks are an effective strategy for postoperative pain management in breast surgeries, reducing opioid use and its adverse effects, while promoting better patient recovery.

analgesia; breast; opioid analgesics; pain; postoperative pain

Introdução O controle adequado da dor pós-operatória em cirurgias de mamárias reduz complicações, melhora o conforto do paciente e diminui o consumo de opioides. Os bloqueios do nervo peitoral (pectoralis nerve, PECS, em inglês) I e II são técnicas analgésicas periféricas eficazes nesse contexto, pois promovem estabilidade hemodinâmica e recuperação mais rápida. Este artigo revisa a literatura sobre a eficácia do bloqueio PECS na analgesia para cirurgia de mama e sua relação com a redução do uso de opioides.
Materiais e Métodos A base de dados PubMed foi sistematicamente pesquisada utilizando os descritores cirurgia mamária, bloqueio de nervo peitoral e consumo de opioide. Foram incluídos ensaios clínicos publicados entre janeiro de 2016 e abril de 2023, em português, inglês e espanhol, que avaliaram o efeito dos bloqueios PECS I e II em cirurgias mamárias, considerando controle da dor, uso de opioides, necessidade de antieméticos, tempo de internação e complicações. Após aplicação dos critérios de elegibilidade, 14 estudos foram selecionados.
Resultados O bloqueio PECS demonstrou superioridade na analgesia pós-operatória e redução do consumo de opioides quando comparado a anestesia geral e a outros bloqueios interfasciais, além demenor necessidade de analgesia de resgate emenores taxas de complicações.
Conclusão O bloqueio PECS é uma estratégia eficaz no controle da dor pós-operatória em cirurgias mamárias, pois reduz a necessidade de opioides e seus efeitos adversos, o que favorece a recuperação do paciente.

Palavras-chave: analgesia; dor; dor pós-operatória; mama; analgésicos opioides