Comparative evaluation of PECS II versus RISS block for postoperative analgesia in breast cancer surgery: a randomized controlled trial.

Abstract

Objective: This study aimed to investigate the analgesic effects of Pectoral Nerve Block Type II (PECS II) versus Rhomboid Intercostal and Subserratus Plane Block (RISS) after modified radical mastectomy (MRM) for breast cancer.

Methods: This prospective, double-blind, randomized controlled trial recruited 67 female patients undergoing unilateral MRM from December 1, 2023, to December 1, 2024 at Inner Mongolia Baogang Hospital. Patients were randomly assigned (1:1) to the PECS II group (n=30) or the RISS group (n=30). Primary outcomes included Quality of Recovery (QoR-40) scores at 6 and 24 hours and Visual Analogue Scale (VAS) pain scores in the PACU and at 2, 6, 12, 24, and 48 hours postoperatively. Secondary outcomes included sufentanil consumption via PCIA, the number of effective compressions, remifentanil use during surgery, additional analgesic administrations, sleep quality, and adverse events.

Results: The PECS II group demonstrated significantly lower VAS scores than the RISS group at rest and during movement in the PACU and at 2, 6, 12, and 24 hours (P<0.05). The QoR-40 score at 6 hours was significantly higher in the PECS II group (P<0.0001). The remifentanil consumption, sufentanil dosage and effective compressions via PCIA during surgery were also significantly lower in the PECS II group, compared to the RISS group (P<0.0001).

Conclusion: PECS II block appears to be a more effective analgesic technique than RISS block for patients undergoing breast cancer surgery, providing better pain control, reducing opioid consumption, and potentially facilitating faster recovery.