Comparison of Efficacy of Pectoral Nerve Block-1 Vs Modified Pectoral Block 2 in MRM (Modified Radical Mastectomy) in Terms of Postoperative Pain and Analgesia Requirement

Abstract

Background: PEC-1 and PEC-2 are two innovative inter-fascial plane blocks that have demonstrated the ability to offer exceptional pain relief following modified radical mastectomy procedures.

Objective: The objective of this study was to conduct a comparative analysis of PEC-1 and PEC-2 blocks in relation to post-operative pain, analgesia necessity, and analgesia consumption within the initial 24 hours following a mastectomy with axillary lymph node dissection.

Subjects and Methods: This quasi-experimental study was conducted at department of surgery Jinnah Hospital Lahore for six months from January 2026 to July 2026. Eighty patients were divided into two groups; 40 each. In Group A, patients underwent surgery with general anesthesia + pectoral 1 block. In group B, patients underwent surgery under general anesthesia + modified pectoral block 2. Duration of surgery was noted. During first 24 hours, patients were asked to report pain in terms of visual analogue scale. Total analgesia consumption in first 24 hours was noted. All information was collected on Performa, entered & analyzed through SPSS version 21. A p value < 0.05 was considered significant.

Results: The age distribution showed minimal variation between the PEC 1 Group (mean age: 53.89 ± 5.82) and the Modified PEC 2 Group (mean age: 56.16 ± 6.1) (P = 0.879). The duration of surgery was comparable between the groups, with mean durations of 89.51 ± 15.145 minutes for PEC 1 and 89.27 ± 12.149 minutes for Modified PEC 2 (P = 1.231). At 6 hours, the PEC 1 Group reported a pain score of 0.5 ± 0.628, significantly higher than the Modified PEC 2 Group's score of 0.04 ± 0.20 (P = 0.007). Similar trends were observed at 24 hours (PEC 1: 3.39 ± 1.37, Modified PEC 2: 2.8 ± 0.81, P = 0.04) for pain at rest. The Modified PEC 2 Group showed a notable reduction in the need for rescue analgesia compared to the PEC 1 Group. The differences were statistically significant (P < 0.05) at all time intervals.

Conclusion: In the conclusion it is seen that in the outcome of PECs I block vs modified PECs II block in modified radical mastectomy, PEC II is superior.