Work

Association of Ultrasound-Guided PECS II Block with Postoperative Pain Scores and Recovery Outcomes in Subpectoral Breast Augmentation: A Retrospective Cohort Study

Year: 2026

Type: article

Abstract: Purpose: Breast augmentation is one of the most frequently performed aesthetic surgical procedures. This study evaluated whether adding pectoral nerve II (PECS II) block to standard multimodal analgesia, as part of a multidisciplinary perioperative pain-management strategy, was associated with improved early postoperative outcomes in patients undergoing breast augmentation. Patients and Methods: This retrospective study reviewed anesthesia records of 48 patients undergoing subpectoral breast augmentation between April 15, 2024, and November 1, 2025. Patients receiving an ultrasound-guided PECS II block in addition to standard multimodal analgesia were compared with patients receiving multimodal analgesia alone. The primary outcome was the highest post-anesthesia care unit (PACU) Visual Analog Scale score (VAS). Secondary outcomes included intraoperative remifentanil consumption, rescue meperidine use, PACU length of stay (PACU LOS), ward rescue analgesia, and block-related complications. Results: A total of 48 patients were analyzed, including 27 in the PECS II block group and 21 in the control group. PACU VAS scores were lower in the PECS II block group than in controls (median [interquartile range]: 1 [0-2] vs 4 [3-6], p < 0.001). Intraoperative remifentanil consumption was lower in the PECS II block group (p = 0.009). VAS score ≥4 requiring protocol-driven rescue meperidine occurred in 71.4% of control patients but in none of the PECS II block patients (p < 0.001). PACU LOS was significantly shorter in the PECS II block group (p < 0.001). These associations persisted after multivariable adjustment. Ward rescue tramadol use did not differ significantly between groups (p = 0.186). No block-related complications were documented. Conclusion: Ultrasound-guided PECS II block combined with multimodal analgesia was associated with improved postoperative analgesia, reduced opioid requirements, and shorter PACU LOS. These findings support its potential integration into multidisciplinary perioperative care after subpectoral breast augmentation. Further prospective studies are warranted to confirm these findings.

Source: Journal of Multidisciplinary Healthcare

DOI: 10.2147/jmdh.s649678