| Influence of psychological factors on the benefit from interpectoral and pectoserratus plane block for recovery after partial mastectomy: a randomized controlled trial |
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Sung Yeon Ham1,2, Jooyoung Oh3,4, Ji Yeong Kim1, Juyeong Park4, Hye Sun Lee5, Soong June Bae6,7, Seung Ho Baek6,7, Yoonwon Kook6,7, Joon Jeong6,7, Sung Gwe Ahn6,7, Young Song1,2 |
1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
2Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
3Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
4Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
5Department of Research Affairs, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
6Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
7Institute for Breast Cancer Precision Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea |
Corresponding author:
Sung Gwe Ahn, Tel: +82-2-2019-6095, Fax: +82-2-3463-0940,
Email: nearmyheart@yuhs.ac
Young Song,
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Received: 11 July 2024 • Revised: 16 February 2025 • Accepted: 16 February 2025
*Sung Yeon Ham and Jooyoung Oh contributed equally to this study as co-first authors. |
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| Abstract |
Background
The interpectoral and pectoserratus plane (PECs) blocks have been reported to provide favorable postoperative analgesia after mastectomy. However, studies have reported controversial data regarding its effect on the quality of recovery (QoR). We aimed to evaluate the effect of the PECs block in light of baseline psychological factors and pain sensitivity.
Methods
Patients undergoing partial mastectomy were randomly assigned to receive either a PECs block (PECs group, n = 69) or no block (control group, n = 70). We assessed the preoperative psychosocial factors and pain recognition using the Hospital Anxiety Depression Scale (HADS), Pain Catastrophizing Scale (PCS), Breast Cancer Pain Questionnaire (BCPQ), temporal pain summation (TPS), and pressure pain threshold and tolerance; we then conducted the interaction test to evaluate the moderating role of these factors on the efficacy of the PECs block.
Results
The global QoR-15 score 1 d after surgery did not differ between the groups (136.50 [124.00, 144.00] vs. 141.00 [127.00, 148.00], P = 0.061); however, the score was enhanced in patients who were depressed, did not ruminate pain aberrantly, and did not have pre-existing pain. The pain Verbal Numeric Rating Scale (VNRS) 1 d after surgery was not different between the groups; however, the TPS score showed an interaction, indicating that the PECs block could reduce pain intensity in patients with high pain sensitivity.
Conclusions
The PECs block did not enhance the QoR-15 score or pain intensity after mastectomy, but its efficacy was pronounced in patients with several specific emotional traits and pain perception. |
| Key Words:
Breast surgery; Effect modification; Interpectoral plane block; Moderating role; Pectoserratus plane block; Quality of recovery |
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