Evaluation of the postoperative analgesic efficacy of a catheter placed into the pectoral region using an open technique in patients undergoing modified radical mastectomies, a clinical trial

Objectives: The aim of this study was to examine the effects of local anesthetics delivered through a catheter inserted in the pectoral and axillary nerves using an open technique to treat persistent post-mastectomy pain syndrome (PPMPS). Design: A randomized, prospective, clinical study Setting: Istanbul University- Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey Subject: Eighty-six adult females aged 18-80 years who underwent modified radical mastectomy (MRM) Interventions: At the end of the surgery, group I was infused with 100 mg tramadol. Group II had a peripheral block catheter placed in the pectoral area just before closing the surgical area. Main outcome measures: All patients were evaluated for postoperative 1-24 hr visual analog scores (VAS), mean arterial pressure, heart rate, postoperative nausea and vomiting (PONV), and additional analgesic requirements. Motor and sensorial block levels were examined. Results: The immobile and mobile VAS scores at all time intervals, PONV scores, and 90th day median VAS scores were lower in group II than in group I (P<0.001, P<0.01, P<0.001, P<0.01, respectively). More patients used additional analgesic in group I than in group II (P<0.0001). Conclusions: Local anesthesia given through a peripheral block catheter placed on the brachial plexus in patients undergoing MRM may be effective in preventing PPMPS.