Comparative Analysis of Early Recovery Profiles Following General Anesthesia with and without Pectoral Nerve Block2 in Modified Radical Mastectomy

Background: Modified radical mastectomy (MRM) is often associated with significant postoperative pain, which can delay recovery and increase opioid requirements. The use of regional blocks like Pectoral Nerve Block II (PECS II) as an adjunct to general anesthesia may enhance postoperative better outcome. Methods: This randomized controlled study was conducted to compare early recovery profiles, hemodynamic parameters, and postoperative analgesia in patients undergoing MRM under general anesthesia (GA) alone and GA combined with PECS II block at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from September 2021 to October 2022. A total of 60 female patients aged 30–60 years (ASA grade I–II) were randomly assigned into two groups: Group A received GA alone, while Group B received GA with PECS II block. Results: The demographic characteristics were comparable between the two groups. Pain scores during recovery and 6 hours postoperatively were significantly lower in Group B (p<0.001). Group B had a delayed time to first rescue analgesia (144.0 ± 68.9 min vs. 38.0 ± 13.5 min; p=0.001) and significantly reduced total pethidine consumption (72.5 ± 7.9 mg vs. 120.0 ± 10.0 mg; p<0.001). A higher proportion of patients in Group B achieved a modified Aldrete score >9 (76.7% vs. 20.0%; p<0.001) and reported very high satisfaction (73.4% vs. 6.6%; p<0.001). Heart rate was consistently higher in Group A during and after surgery (p<0.05), while mean arterial pressure showed no significant difference. Conclusion: The addition of Pectoral Nerve Block II to general anesthesia in modified radical mastectomy significantly improves postoperative pain control, reduces opioid requirement, enhances recovery, and increases patient satisfaction without compromising hemodynamic stability.