{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:01:29Z","timestamp":1791223289292,"version":"4.1.0"},"reference-count":37,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2019,7,8]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background and objectives<\/jats:title>\n                  <jats:p>Several studies have evaluated the effect of pectoral nerve blocks to improve postoperative analgesia following breast cancer surgery resulting in contradictory findings. The aim of this study was to examine the effect of Pecs blocks on postoperative analgesia in women following mastectomies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a quantitative systematic review in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Articles of randomized controlled trials that compared Pecs block (types I and II) to a control group in patients undergoing mastectomy were included. The primary outcome was total opioid consumption 24\u2009hours after surgery. Secondary outcomes included pain scores and side effects. Meta-analysis was performed using the random effect model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>7 randomized controlled trials with 458 patients were included in the analysis. The effect of pectoral nerve blocks on postoperative opioid consumption compared with control revealed a significant effect, weighted mean difference (WMD) (95%\u2009CI) of -\u22124.99 (\u22127.90 to \u22122.08)\u2009mg intravenous morphine equivalents (p=0.001). In addition, postoperative pain compared with control was reduced at 6\u2009hours after surgery: WMD (95%\u2009CI) of \u22120.72 (\u22121.37 to \u22120.07), p=0.03, and at 24\u2009hours after surgery: WMD (95%\u2009CI) of \u22120.91 (\u22121.81 to \u22120.02), p=0.04.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This quantitative analysis of randomized controlled trials demonstrates that the Pecs block is effective for reducing postoperative opioid consumption and pain in patients undergoing mastectomy. The Pecs block should be considered as an effective strategy to improve analgesic outcomes in patients undergoing mastectomies for breast cancer treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2019-100658","type":"journal-article","created":{"date-parts":[[2019,8,10]],"date-time":"2019-08-10T06:25:12Z","timestamp":1565418312000},"page":"923-928","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Pectoral nerve blocks and postoperative pain outcomes after mastectomy: a meta-analysis of randomized controlled trials"],"prefix":"10.1136","volume":"44","author":[{"given":"Danielle","family":"Lovett-Carter","sequence":"first","affiliation":[{"name":"Division of Biology and Medicine, Brown University, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark C","family":"Kendall","sequence":"additional","affiliation":[{"name":"Division of Biology and Medicine, Brown University, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary L","family":"McCormick","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward I","family":"Suh","sequence":"additional","affiliation":[{"name":"Division of Biology and Medicine, Brown University, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander D","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Biology and Medicine, Brown University, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gildasio S","family":"De Oliveira","sequence":"additional","affiliation":[{"name":"Division of Biology and Medicine, Brown University, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,9]]},"reference":[{"key":"2025101111313789000_44.10.923.1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000695"},{"key":"2025101111313789000_44.10.923.2","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1111\/anae.14424","article-title":"A randomised trial of serratus anterior plane block for analgesia after thoracoscopic surgery","volume":"73","author":"Park","year":"2018","journal-title":"Anaesthesia"},{"key":"2025101111313789000_44.10.923.3","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.jclinane.2017.12.001","article-title":"A comparison between inhalational (desflurane) and total intravenous anaesthesia (propofol and dexmedetomidine) in improving postoperative recovery for morbidly obese patients undergoing laparoscopic sleeve gastrectomy: a double-blinded randomised controlled trial","volume":"45","author":"Elbakry","year":"2018","journal-title":"J Clin Anesth"},{"key":"2025101111313789000_44.10.923.4","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000768"},{"key":"2025101111313789000_44.10.923.5","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/anae.14157","article-title":"The enhanced recovery after surgery (ERAS) Greenie board: a Navy-inspired quality improvement tool","volume":"73","author":"Smirk","year":"2018","journal-title":"Anaesthesia"},{"key":"2025101111313789000_44.10.923.6","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jclinane.2018.05.012","article-title":"A comparison of the fascia iliaca block to the lumbar plexus block in providing analgesia following arthroscopic hip surgery: a randomized controlled clinical trial","volume":"49","author":"Badiola","year":"2018","journal-title":"J Clin Anesth"},{"key":"2025101111313789000_44.10.923.7","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000641"},{"key":"2025101111313789000_44.10.923.8","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1111\/anae.14213","article-title":"Combined thoracic paravertebral and pectoral nerve blocks for breast surgery under sedation: a prospective observational case series","volume":"73","author":"Pawa","year":"2018","journal-title":"Anaesthesia"},{"key":"2025101111313789000_44.10.923.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.006"},{"key":"2025101111313789000_44.10.923.10","unstructured":". 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