Arrhythmias & electrophysiology
Intraoperative pectoral nerve blocks during cardiac implantable electronic device procedures
Authors' conclusion
Intraoperative PECs block can reduce postoperative pain and opioid use.
Study context
- Population
- Patients undergoing pectoral cardiac implantable electronic device (CIED) procedures at 7 centres, 2022–2023
- Participants
- 610 patients
- Exposure
- Intraoperative PECs block plus subcutaneous local anaesthetic vs subcutaneous local anaesthetic only
- PECs blockn = 305
- Outcome
- Postoperative pain score
- Follow-up
- 4 hours after the procedure
Methodological detailsmulticentre, 7 centres, non-randomised (operator discretion), History of chronic pain more frequent with PECs block (32% vs 11%, P <.001)
- Multicentre
- 7 centres
- Non-randomised (operator discretion)
- History of chronic pain more frequent with PECs block (32% vs 11%, P <.001)
Main finding
As reported in the abstract
Pain score
PECs block
1.5
SD 2.1
Local anesthetic only
4.5
SD 2.5
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Inpatient opioids10% vs 48%; less likely with PECs block | P < 0.001 |
| Discharged with opioid prescription15% vs 59%; less likely with PECs block | P < 0.001 |
Pain score · 24 hours
- Pain scores not different, PECs block vs local anesthetic only
- 2.8 ± 1.7 vs 3.1 ± 2.2
Pain score · 2 weeks
- Pain scores not different, PECs block vs local anesthetic only
- 0.9 ± 1.4 vs 0.9 ± 1.2
Factors associated with lower acute postoperative pain (multivariable linear regression)
- PECs block
- P < 0.001
- Age
- P = 0.002
- Absence of chronic pain
- P = 0.009
Original publication
Intraoperative pectoral nerve blocks during cardiac implantable electronic device procedures. Heart Rhythm. Published 24 August 2024. doi:10.
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