Analgesic Effectiveness of Ultrasound-Guided PECS II Block in Implantable Venous Port Catheter Placement: A Retrospective Comparative Study

Background and Objectives: Total implantable venous access port (TIVAP) placement is a frequently performed but potentially painful procedure in oncology patients. This study aimed to compare the analgesic effectiveness, sedation requirements, and patient comfort associated with ultrasound-guided PECS II block versus conventional local infiltration anesthesia during TIVAP placement. Materials and Methods: Data from 118 patients who underwent TIVAP placement between 2021 and 2024 were retrospectively reviewed. Patients were divided according to the anesthesia method used: local infiltration (n = 64) and ultrasound-guided PECS II block (n = 54). The primary outcome was postoperative pain, assessed using the Visual Analog Scale (VAS), while secondary outcomes included requirements for additional local anesthetic, sedation and rescue analgesia, patient satisfaction, hemodynamic parameters, and procedure-related complications. Results: PECS II block was associated with lower VAS scores during the early postoperative period. Sedation was required in 11.1% of patients in the PECS II group and 56.3% in the infiltration group, while rescue analgesia was required in 11.1% and 82.8%, respectively (both p < 0.001). Patient satisfaction was higher in the PECS II group (p < 0.001). Any recorded procedure-related complication occurred in 7.4% of patients in the PECS II group and 20.3% in the infiltration group (Pearson chi-square p = 0.047); individual complication types were infrequent. Conclusions: In this retrospective cohort, PECS II block was associated with lower postoperative pain scores and reduced requirements for sedation and rescue analgesia compared with local infiltration anesthesia. These findings support PECS II block as a potential component of multimodal analgesia for TIVAP placement, while prospective randomized studies are needed for confirmation.