Pain Control After Mastectomy in Transgender Patients: Ultrasound-guided Pectoral Nerve Block II Versus Conventional Intercostal Nerve Block: A Randomized Clinical Trial

AuthorFaranak Rokhtabnaken
AuthorSoheila Sayaden
AuthorMaryam Izadien
AuthorSoudabeh Djalali Motlaghen
AuthorPoupak Rahimzadehen
OrcidFaranak Rokhtabnak [0000-0001-6368-9931]en
OrcidSoheila Sayad [0000-0003-3904-7394]en
OrcidSoudabeh Djalali Motlagh [0000-0002-5498-678X]en
OrcidPoupak Rahimzadeh [0000-0002-9042-3925]en
Issued Date2021-10-31en
AbstractBackground: Mastectomy is sometimes performed in transgender patients, which may damage the regional nerves such as the pectoral and intercostobrachial nerves, leading to postoperative pain. An ultrasound-guided nerve block can be used to track and block the nerves properly. Objectives: This study aimed to compare the ultrasound-guided type-II pectoral nerve block with the blind (conventional) intercostal nerve block (ICNB) for pain control after breast tissue reconstruction surgery in transgender patients. Methods: In the present single-blind randomized clinical trial, 47 patients were randomly divided into two groups: (A) Ultrasound-guided type-II pectoral nerve block (n = 23) and (B) blind intercostal nerve block (n = 24). After nerve block in both groups, pain intensity at 3, 6, 12, and 24 hours after surgery, upper limb paresthesia, frequency of nausea and vomiting, shortness of breath, hematoma, and the length of hospital stay were assessed. Results: Patients who received the ultrasound-guided type-II pectoral nerve block had a greater reduction in pain intensity (24 h after surgery), opioid use (24 h after surgery), nausea, vomiting, and hospital stay than those who received ICNB, whereas the recovery time did not differ between the study groups. Conclusions: The pectoral nerve block under ultrasound guidance, compared to the intercostal nerve block, in transgender patients can reduce the required dosage of opioids within 24 hours, pain intensity within 24 hours after surgery, the incidence of postoperative nausea, and vomiting, and the hospital stay of patients.en
DOIhttps://doi.org/10.5812/aapm.119440en
KeywordIntercostal Nerve Blocken
KeywordMastectomyen
KeywordPectoral Nerve Blocken
KeywordTransgenderen
KeywordUltrasound Guidanceen
PublisherBrieflandsen
TitlePain Control After Mastectomy in Transgender Patients: Ultrasound-guided Pectoral Nerve Block II Versus Conventional Intercostal Nerve Block: A Randomized Clinical Trialen
TypeResearch Articleen

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