{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T15:13:39Z","timestamp":1769267619137,"version":"3.49.0"},"reference-count":9,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Regional anesthesia is an important aspect of the overall anesthetic plan for patients. It has the potential to offer superior benefits compared to opioid-based treatment and is an important component of Enhanced Recovery after Surgery (ERAS) protocols. The use of the pectoral type I (PECS I) and pectoral type II blocks (PECS II) has been shown to reduce postoperative pain and opioid consumption in patients undergoing complete mastectomy and breast surgery. We describe the use of dexamethasone and dexmedetomidine to prolong the analgesic effects of these regional blocks in a patient undergoing total mastectomy with lymph node dissection.<\/jats:p>","DOI":"10.3390\/clinpract11020027","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T03:29:45Z","timestamp":1617074985000},"page":"190-192","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Synergistic Effects of Dexamethasone and Dexmedetomidine in Extending the Effects of Pectoral I and Pectoral II Blocks for Postoperative Analgesia Following Total Mastectomy with Lymph Node Dissection"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5393-4569","authenticated-orcid":false,"given":"Ahish","family":"Chitneni","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, A.T. Still University School of Osteopathic Medicine in Arizona, Mesa, AZ 63501, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamal","family":"Hasoon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3652-6085","authenticated-orcid":false,"given":"Ivan","family":"Urits","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Viswanath","sequence":"additional","affiliation":[{"name":"Valley Anesthesiology and Pain Consultants, Envision Physician Services, Phoenix, AZ 85014, USA"},{"name":"Department of Anesthesiology, University of Arizona College of Medicine Phoenix, Phoenix, AZ 85724, USA"},{"name":"Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE 68178, USA"},{"name":"Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA 71115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2464-0187","authenticated-orcid":false,"given":"Alan D.","family":"Kaye","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA 71115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Eskander","sequence":"additional","affiliation":[{"name":"Anesthesiology and Pain Medicine, Portsmouth Anesthesia Associates, Portsmouth, VA 23707, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"i90","DOI":"10.1093\/bja\/aer340","article-title":"Does regional anaesthesia really improve outcome?","volume":"107","author":"Kettner","year":"2011","journal-title":"Br. J. Anaesth."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1111\/j.1365-2044.2011.06838.x","article-title":"The \u2018pecs block\u2019: A novel technique for providing analgesia after breast surgery","volume":"66","author":"Blanco","year":"2011","journal-title":"Anaesthesia"},{"key":"ref_3","first-page":"470","article-title":"Ultrasound description of Pecs II (modified Pecs I): A novel approach to breast surgery","volume":"59","author":"Blanco","year":"2012","journal-title":"Rev. Esp. Anest. Reanim."},{"key":"ref_4","first-page":"1","article-title":"Efficacy of pectoral nerve block type II for breast-conserving surgery and sentinel lymph node biopsy: A prospective randomized controlled study","volume":"2018","author":"Kim","year":"2018","journal-title":"Pain Res. Manag."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2217\/pmt-2019-0054","article-title":"Impact of preoperative pectoralis plane nerve blocks for mastectomy on perioperative opioid consumption: A retrospective study","volume":"10","author":"Kim","year":"2020","journal-title":"Pain Manag."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1089\/lap.2017.0337","article-title":"The role of transversus abdominis plane blocks in enhanced recovery after surgery pathways for open and laparoscopic colorectal surgery","volume":"27","author":"Kim","year":"2017","journal-title":"J. Laparoendosc. Adv. Surg. Tech."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Chen, Q., An, R., Zhou, J., and Yang, B. (2018). Clinical analgesic efficacy of dexamethasone as a local anesthetic adjuvant for transversus abdominis plane (TAP) block: A meta-analysis. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0198923"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"109703","DOI":"10.1016\/j.jclinane.2020.109703","article-title":"Synergistic effect of local dexamethasone and dexmedetomidine (Dex-Dex) in extending the analgesic effect of a transversus abdominis plane block prior to inguinal hernia repair","volume":"62","author":"Herman","year":"2020","journal-title":"J. Clin. Anesth."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"109750","DOI":"10.1016\/j.jclinane.2020.109750","article-title":"Synergistic effect of perineural dexamethasone and dexmedetomidine (Dex-Dex) in extending the analgesic duration of a transversus abdominis plane block","volume":"63","author":"Herman","year":"2020","journal-title":"J. Clin. Anesth."}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-7283\/11\/2\/27\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:10:24Z","timestamp":1760364624000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/11\/2\/27"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,30]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["clinpract11020027"],"URL":"https:\/\/doi.org\/10.3390\/clinpract11020027","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,30]]}}}