Regional anesthesia for breast cancer surgery: which block is best? A review of the current literature.

Abstract

Breast cancer is the most common type of cancer worldwide. Fortunately, continual advances in diagnosis and treatment are resulting in increased survival rates. Earlier detection and treatment, to include surgical resection, can greatly improve patientsoutcomes. However, due to the complex innervation of the breast, management of postoperative pain has proven difficult in the past. Approximately, half of all women who undergo breast cancer surgery report postoperative pain syndrome. The paravertebral blockhas long been the anesthesiologist's choice for mitigating pain during and after the procedure. Newer techniques such as the pectoral nerve blockand erector spinae plane block may prove to have some additional benefits. This literature review compares the risks, benefitsand specific uses of these three regional nerve blocks in women undergoing breast cancer surgery. It aims to better inform anesthesiologistswhen they are choosing which technique is best for their patients.