Training level and analgesic outcomes of ultrasound-guided nerve blocks in the emergency department: An analysis from the NURVE block registry.

Post-operative pain following arthroscopic rotator cuff repair is challenging. Peripheral nerve blocks are commonly used, but debate remains over single-shot versus continuous interscalene catheters. This trial compared early post-operative pain and opioid use with a single-shot block versus a continuous interscalene catheter. In this prospective, double-blinded randomized controlled trial, 45 patients undergoing arthroscopic rotator cuff repair received an interscalene catheter with an initial single-shot block. They were randomized to either a patient-controlled infusion of normal saline (control, n = 22) or low-dose anesthetic (treatment, n = 23). Visual analogue scale for pain severity (VAS-S) and frequency (VAS-F) were assessed pre-operatively, daily for the first post-operative week, and at 2, 6, and 12 weeks. Opioid consumption was recorded for one week post-operatively. Functional outcomes were measured using the Constant and Western Ontario Rotator Cuff scores, and satisfaction with the surgery was assessed at 12 weeks. A significant interaction effect was found for VAS-S over the first week (P = .041), with the treatment group reporting significantly lower pain on day 1 (P = .011). Both groups showed significant improvement in clinical scores (P < .0001). The treatment group had a higher Constant score at 12 weeks (P = .040), though this did not reach the Minimally Clinically Important Difference. No significant difference in opioid consumption (P = .653) or satisfaction (treatment: 82%, control: 91%) was observed. Continuous interscalene catheters improved early post-operative pain without reducing opioid use. Despite these findings, careful consideration of patient needs, cost-effectiveness, and the potential complications associated with catheter use should be acknowledged in the individual patient's pain management strategy.

The Effect of Pre-Sacral Nerve Block on Post-Operative Pain Following Laparoscopic Hysterectomy

Ultrasound Guided Ankle Block versus Ultrasound Guided Combined Sciatic and Saphenous Nerve Blocks for Anesthesia and Postoperative Analgesia in Foot Surgeries

Aim and objectives: The aim and the objective of the study was to compare and evaluate audio analgesia, aroma therapy, Visual distraction using LASER projector and Snoezelen environment on pain perception and anxiety in children undergoing dental treatment requiring IANB in children 6-10 years. Materials and method: A sample size of 50 was taken and the participants were divided into five groups: Group 1: Control group, GROUP 2: Audio analgesia, Group 3: Aroma therapy, Group 4: Visual distraction using LASER projector, Group 5: Snoezelen environment. After administration of local anesthesia Pain perception was evaluated by the FIS and anxiety was evaluated by the pulse rate and oxygen saturation level by using Pulse oximeter. The results of this study were tabulated and statistically analyzed. Result: The Snoezelen Environment was found to be significantly more effective as compared to audio analgesia, aroma therapy and visual distraction using laser projector. Used separately in children undergoing procedures requiring an inferior alveolar nerve block. Conclusion: The Snoezelen Environment proved most effective, for reducing anxiety and pain in children undergoing procedures requiring an IANB.

Abstract Introduction: Inferior alveolar nerve block has a limited success during endodontic management of teeth with symptomatic irreversible pulpitis (SIP). Hence, various therapies, such as aromatherapy, acupuncture are advised due to their high safety level. This trial aimed to evaluate the effect of low-level laser therapy-activated Hegu acupoint on pain during anesthetic solution deposition and access opening in teeth with SIP. Materials and Methods: 68 healthy adults, aged between 18-40 years, with SIP in mandibular molars and satisfying inclusion criteria, were categorized into Group I (laser acupuncture [Lac]) and Group II (Control, sham LAc [SLAc] – use of similar low-level laser therapy setting without activation). In the LAc group, the ipsilateral Hegu acupoint of the participant was laser irradiated in a contact mode, and the Deqi sensation (in the form of 12 descriptors like soreness, aching, deep pressure etc.) was assessed using a Massachusetts General Hospital Acupuncture Sensation Scale. In the SLAc group, the same procedure was repeated except that the laser was kept in “off mode” to avoid any bias in the perception of participants. Root canal treatment was initiated under inferior alveolar nerve block, and the patient’s anesthetic solution deposition and access opening pain scores were marked on Visual Analog Scale. The Mann–Whitney U - and Chi-square tests were applied. Results: Participants in the LAc group had significantly lower pain scores compared to those in the SLAc group during anesthetic solution deposition and access opening ( P &lt; 0.001). Conclusion: Needless acupuncture can be considered a safe, noninvasive, and efficient complementary treatment modality to improve inferior alveolar nerve block success.

Abstract Objectives: Incurable pancreatic cancer poses challenging analgesic requirements, which subsequently affect the quality of life of patients. The aim of this review was to assess the available methods of managing pain in incurable pancreatic cancer, how these are utilized, and their effectiveness in patients. Data Sources: A comprehensive literature search was conducted of online databases, including Medline and Embase, using MeSH terms. The study was registered with PROSPERO number 1164775. Study Selection: Inclusion and exclusion criteria included patients &gt;18 years and a sample size &gt;40. This resulted in 9 papers being included in the study. Secondary outcomes included functional status, quality of life, anxiety, and depression. Results: The studies focused on various regional nerve blocks and oral analgesia. These used a numerical analogue scale as a self-reported outcome measure of pain. Results found that oral combination analgesia provided better analgesic effects than monotherapy. This was similarly found to have improved quality of life and psychological well-being. Eight studies found nerve blocks to be a more effective method of treating pain than oral analgesia alone. Conclusion: By using combination analgesics, studies found that reduced doses of opioids were required, thus reducing side effects. Celiac plexus blocks were found to be associated with lower opioid requirements and subsequently less side effects, particularly in the initial months following treatment. This demonstrates an important option in pain management for patients with complex pain in advanced pancreatic cancer.

Extended-release opioids (EROs) are not recommended for acute postoperative pain, yet their prescribing persists. This study examined the incidence, predictors, and variation in ERO dispensing after total hip and knee arthroplasty. We conducted a population-based cross-sectional study of adults undergoing primary total hip or knee arthroplasty between 2013 and 2022 using linked administrative databases in Ontario, Canada. The primary outcome was fulfillment of an ERO prescription within seven days of discharge. Multilevel logistic regression estimated associations between patient, surgical, anesthetic, and hospital factors and filling an ERO prescription. Variation was quantified using variance partition coefficients (VPCs) and median odds ratios (MOR) with 95% confidence intervals (CI), based on random effects. Among 229,995 knee and hip arthroplasty procedures, 27,915 (12.1%) patients filled a new ERO prescription post-discharge. Male sex (OR 1.14, 95% CI 1.09-1.19), preoperative opioid exposure (Opioid Naïve-Exposed-Tolerant (ONET) Score 2 OR 1.21, 95% CI 1.15-1.27; ONET 3 OR 1.38, 95% CI 1.20-1.58), and ASA 3 status (OR 1.07, 95% CI 1.01-1.12) increased odds of filling a new ERO prescription. Neuraxial anesthesia (OR 0.79, 95% CI 0.74-0.84), peripheral nerve block (OR 0.84, 95% CI 0.79-0.89), and acute pain service involvement (OR 0.77, 95% CI 0.70-0.85) were protective against filling a new ERO prescription. Substantial variation was found across hospitals (VPC 46%, 95% CI 0.4-0.54; MOR 9.3, 95% CI 6.57-15.27) and surgeons (VPC 26%, 95% CI 0.24-0.26; MOR 5.3, 95% CI 4.63-6.11), with minimal anesthetist-level variation (VPC 1%, 95% CI 0.010-0.011; MOR 1.4, 95% CI 1.36-1.46). Patient-level factors explained a minority of variation. One in ten patients fills an ERO prescription after total hip or knee arthroplasty, a practice with high variation that is predominantly driven by institutional and surgical practice patterns rather than patient factors. Future research should explore institutional stewardship, standardized discharge protocols, and multidisciplinary engagement to reduce unnecessary postoperative exposure to EROs.

Objective: To summarize the clinical evidence regarding anesthetic techniques for transfemoral transcatheter aortic valve implantation (TF-TAVI) and to propose a practical decision-making algorithm. Methods: A comprehensive literature search was conducted across PubMed and Cochrane databases using keywords including "TAVI," "transfemoral," "local anesthesia," "conscious sedation," "regional anesthesia," and "nerve block." Recent and clinically relevant studies were selected for qualitative synthesis. Results: Based on the literature review, local anesthesia combined with conscious sedation (CS/LA) has been demonstrated to be non-inferior to general anesthesia regarding short-term clinical outcomes while maintaining a comparable safety profile during long-term follow-up. Meta-analyses and registry data suggest modest but consistent and feasible early benefits. Therefore, LA/CS should be considered the default strategy for TF-TAVI. Regional anesthesia (RA) serves as an effective adjunct: ilioinguinal/iliohypogastric blocks (II-IHB) are preferred, while fascia iliaca block (FIB) or transversus abdominis plane block (TAPB) may be considered for severe lower abdominal wall pain or to achieve prolonged analgesia. Spinal anesthesia (SA) should only be reserved for highly selected cases, requiring precise dose titration and rigorous hemodynamic monitoring. Conclusions: CS/LA remains the gold standard for TF-TAVI. Adjunctive RA enhances the quality of anesthesia and reduces systemic anesthetic consumption. SA should be utilized selectively. Further multicenter randomized controlled trials are warranted to standardize anesthetic algorithms for TF-TAVI.

Point-of-care ultrasound-guided fascia iliaca nerve block (POCUS-FINB) is an effective method for pain control in children with femur fractures. Many pediatric emergency medicine (PEM) providers have not been trained in this technique, and there is no standard curriculum. While other studies have evaluated in-person POCUS-FINB didactics, assessment of online educational interventions is lacking. We created and implemented a novel online POCUS-FINB module and evaluated its efficacy in knowledge, confidence, and technical skill acquisition among PEM physicians. This was a prospective presurvey and postsurvey study of PEM attendings and fellows. The curriculum was developed using the Kern 6-step framework and included an online module and a brief hands-on session. Confidence, knowledge, and technical skills were assessed using a Likert scale, multiple-choice tests, and an observation checklist, respectively. In addition, we reviewed the proportion of eligible patients who received POCUS-FINB at our institution precurriculum and postcurriculum implementation. Twenty-seven PEM physicians in 2 pediatric emergency departments participated in the study. Twenty-two completed all assessments from January 2022 to July 2023. Physicians demonstrated improved confidence with POCUS-FINB methods after completion of the online curriculum, with 4% reporting being confident or very confident before and 71% after the module (P<0.001). On the knowledge test, there was a statistically significant improvement, with mean scores from 77% premodule to 95% postmodule (P<0.001). Immediately after the module, participants scored well in technical skills with a mean score of 92%. There was a significant increase in the proportion of eligible patients with femur fractures who received blocks over the study period, 19% during the premodule period and 38% during the postmodule period (P=0.046). After completing a web-based curriculum for POCUS-FINB, PEM physicians showed improvement in confidence and knowledge and performed well in their technical skills.

Achieving adequate analgesia in patients undergoing vaginoplasty facilitates early ambulation, reduces postoperative morbidity and increases patient satisfaction. This study evaluated the use of intraoperative nerve blocks (transverse abdominis plane [TAP] block and perineal block) in reducing postoperative pain and decreasing opioid use in robotic-assisted peritoneal flap vaginoplasty. A prospective cohort study of 150 consecutive adult patients undergoing robotic peritoneal flap vaginoplasty performed by the senior authors was conducted at a single institution from December 2023 to October 2024. 75 consecutive patients who did not receive a block and 75 consecutive patients who did receive blocks were included based upon power analysis calculations with assumptions yielding 99% power. Demographic data as well as multimodal analgesic use was compared between groups with respect to use during the preoperative, intraoperative, and post anesthesia phases of care, as well as on each day of inpatient admission. Groups did not differ significantly in baseline characteristics. Block-treated patients demonstrated a significantly reduced total opioid requirement throughout their hospital stay, inclusive of intraoperative and perioperative dosing, as measured in total morphine milligram equivalents (MME) (median 675 versus 26 MME; p < 0.001). Block-treated patients required almost no oxycodone or hydromorphone after surgery with a median oxycodone dose of 0 mg compared with 33 mg in controls (p < 0.001); their total median hydromorphone dose was 0.4 mg versus 1.2 mg (p < 0.001). The block intervention achieved a dramatic reduction in total postoperative opioid use (oral and intravenous) throughout the hospital stay.

Postoperative pain is a common and distressing complication following surgery, particularly among orthopedic patients, due to extensive tissue injury and invasive procedures. Poorly managed POP can delay recovery, prolong hospital stays, increase complications, and reduce patient satisfaction. Despite the known burden, evidence on patient satisfaction with postoperative pain management among adult orthopedic patients in Ethiopia remains limited. This study aimed to assess patient satisfaction with postoperative pain management and its associated factors among adult orthopedic surgery patients at comprehensive specialized hospitals in the Amhara region from September 17 to December 13, 2025. A multicenter, institutional-based cross-sectional study was conducted among adult orthopedic surgical patients. A total of 423 participants were recruited using a consecutive sampling technique. Data were collected via semi-structured questionnaires adapted from validated tools and supplemented with locally relevant variables. Descriptive statistics were used to summarize participant characteristics, and bi-variable and multivariable logistic regression analyses were performed to identify factors associated with satisfaction. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine the strength of associations, with p-values < 0.05 considered statistically significant. Among the 423 participants, 79.4% (95% CI 75.30, 83.03) reported satisfaction with postoperative pain management. Factors significantly associated with higher satisfaction included undergoing elective surgery (AOR = 2.92, 95% CI 1.58-5.40), having no or low preoperative anxiety (AOR = 2.98, 95% CI 1.67-5.34), receiving preoperative analgesia (AOR = 2.39, 95% CI 1.29-4.40), shorter surgical duration (≤ 1h) (AOR = 3.71, 95% CI 1.11-12.37), and use of peripheral nerve block-based postoperative analgesia (AOR = 2.98, 95% CI 1.27-7.02). Patient satisfaction with postoperative pain management was moderately high and significantly associated with several factors, including anxiety, preoperative analgesia, and perioperative practices such as elective surgery, shorter procedures, and the use of peripheral nerve block analgesia. To enhance postoperative pain control and patient satisfaction, healthcare facilities may consider prioritizing preoperative anxiety management, routine preoperative analgesia, and the consistent use of peripheral nerve block-based analgesia. In resource-limited settings, landmark-based techniques with appropriate provider training may support safe and effective implementation.

The diagnosis of chronic low back pain is frequently complicated by the absence of identifiable pathoanatomical causes on imaging. Consequently, clinical guidelines often advocate for interventional diagnostic procedures, such as medial branch nerve blocks, for suspected facet joint syndrome. Despite their utility, these interventions involve significant resource costs and potential risks associated with needle gauges and pharmacological agents. This study describes a protocol to evaluate percutaneous electrical nerve stimulation (PENS) as a safer, drug-free, and more cost-effective alternative. A parallel and multicenter study with an experimental design through a randomized clinical trial will be conducted. Adults with chronic low back pain and facet-mediated pain confirmed by two positive comparative medial branch diagnostic blocks will be randomized into four parallel groups: PENS, diagnostic medial branch nerve block (with local anesthetic), PENS + nerve block, and PENS + placebo block (full block ritual without active perineural anesthetic). The primary outcomes will be analgesic response. Secondary outcomes include pressure pain threshold, disability, health-related quality of life, rescue analgesic consumption, and the incidence/severity of local and systemic adverse events.Clinical Trial Registration: The www.clinicaltrials.gov identifier is NCT07273006.

Trigeminal neuralgia is a debilitating facial pain condition characterized by recurrent, electric shock-like episodes within the trigeminal nerve distribution. While first-line treatment involves pharmacologic therapy, treatment options are limited for patients who are refractory or poor surgical candidates. We present a 75-year-old female with long-standing idiopathic trigeminal neuralgia refractory to combination anticonvulsant therapy and nerve block, with notable medication-related side effects. The patient underwent percutaneous cryoneurolysis targeting the maxillary (V2) and mandibular (V3) divisions of the trigeminal nerve under fluoroscopic guidance. She experienced immediate pain reduction and complete symptom resolution at a one-month follow-up with no complications. This case highlights percutaneous cryoneurolysis as a minimally invasive treatment option for selected patients with refractory trigeminal neuralgia who are not candidates for open surgical intervention.

Construct a workshop for emergency medicine (EM) residents to learn ultrasound-guided regional anesthesia (UGRA) procedures and build confidence in performing those procedures. Use pre- and post-workshop knowledge and confidence surveys to determine workshop effectiveness. We created a workshop using prosected donors, ultrasound (US) scanning on standardized patients, and needling technique on a phantom model to increase residents' knowledge and confidence for eight UGRA procedures. Pre- and post-workshop assessments are used to measure confidence and knowledge gains. Forty-four EM residents participated in the workshop. Residents scored significantly higher on the post-workshop (n = 29) knowledge assessment compared to the pre-workshop (n = 39) knowledge assessment (12.0 ± 2.0 vs. 8.44 ± 2.45; p < 0.001). Confidence increased significantly on the post-workshop (n = 40) assessment compared to the pre-workshop (n = 28) assessment (p < 0.001). "Extremely confident" and "very confident" statements increased from 11.1% to 45.1% of responses. The self-efficacy gained by residents in this workshop can lead to increased patient safety as opioids are avoided in the emergency department. Workshops such as the one described in this manuscript provide residents and attendings opportunities to learn skills and knowledge for UGRA procedures. This workshop provides EM faculty with an effective environment in which to teach their residents proper skills for UGRA and can be easily replicated at other institutions. Future workshops should include assessment of clinical competency following training.

This systematic review with meta-analysis and trial sequential analysis (TSA) was conducted with the objective of evaluating the effectiveness of oral corticosteroid premedication to achieve profound mandibular anaesthesia in teeth diagnosed with irreversible pulpitis. An electronic search was conducted in PubMed/MEDLINE, Cochrane Library, Embase, Scopus and Web of Science to identify randomized clinical trials that evaluated the effect of oral corticosteroid premedication on the success of mandibular anaesthesia in patients with irreversible pulpitis. The search was performed without date restrictions and limited to trials in English. The risk of bias was assessed using the Cochrane risk of bias tool for randomized trials (RoB 2.0). A random-effects meta-analysis was used to calculate pooled effect risk ratios (RRs) with 95% confidence intervals (CIs). The primary meta-analysis was conducted by including all the trials whilst sensitivity analyses were conducted only on trials with a low risk of bias. Sub-group analyses were performed to assess the dose-response effect. A TSA was performed to evaluate the risks of random errors in the meta-analysis. The overall certainty of evidence was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of 8 trials were included in the review. The primary meta-analysis demonstrated that oral premedication with dexamethasone significantly increased the success rate of inferior alveolar nerve blocks (IANB) compared with a placebo (RR = 1.80; 95% CI, 1.35-2.41). The sensitivity analysis demonstrated a similar result compared to the primary analysis. The sub-group analysis suggested that doses of both 0.5 mg and 4 mg were effective. Oral premedication with dexamethasone had the same effect on IANB success rates when compared to NSAIDs. The TSA confirmed that the evidence for a beneficial effect of oral dexamethasone premedication when compared to placebo for enhancing the anaesthetic efficacy of IANB in teeth with irreversible pulpitis was conclusive. The GRADE was rated as 'moderate' and 'high' when oral corticosteroids were compared with placebo and NSAID, respectively. Oral corticosteroid premedication improves the efficacy of IANB compared to placebo and has a similar effect when compared to NSAIDs in mandibular teeth diagnosed with irreversible pulpitis. PROSPERO (CRD42024508463).

Interscalene brachial plexus block is widely used for pain management in shoulder surgery. However, because of the risk of phrenic nerve palsy, combined suprascapular and axillary nerve blocks (ANBs) are increasingly being used. Although the posterior approach is often used for ANB, several studies have reported on the axillary approach. The purpose of this study was to perform ANB using the axillary approach under ultrasound (US) guidance to investigate the injection point and spread of the solution. 18 fresh-frozen cadaveric specimens (8 male and 10 female specimens) were used in this study, with a mean age of 67.2 years (range, 37-92 years). The cadavers were placed in the lateral position with the upper limb in abduction. The transducer was placed on the axillary fold, and the axillary nerve (AN) was identified in the superficial layer of the humeral head underneath the teres major muscle. Using the in-plane technique, a block needle was inserted posterior to the anterior. 0.1 mL of blue latex solution was injected into 12 specimens (12 shoulders) to confirm the needle tip position, and 10 mL of saline solution colored with methylene blue (MB) was injected into six specimens (six shoulders) to evaluate the spread of the solution. In all cases, the AN was identified by US, and block manipulation was possible. The bifurcation of the anterior and posterior branches of the AN within the quadrilateral space was stained with blue latex solution. The anterior branch of the AN, posterior branch to the deltoid muscle, and posterior branch to the teres minor muscle were stained with MB in all cases. The anterior and posterior branches of the AN were accurately blocked using an US-guided axillary approach. The axillary approach is an effective alternative to the posterior approach.

Trigeminal neuropathic pain (TNP), particularly posttraumatic TNP (PTTN), is often refractory to medical therapy and difficult to manage surgically. Although radiofrequency thermoablation (RFA) of the gasserian ganglion is established, peripheral nerve RFA remains underutilized, particularly in anatomically complex cases. A 62-year-old man developed severe left maxillary (V2) facial pain following sinus surgery, refractory to multiple pharmacological therapies and prior gasserian balloon rhizotomy. A diagnostic infraorbital nerve block produced significant temporary relief, supporting a peripheral pain generator and RFA consideration. An initial infraorbital nerve RFA performed with fluoroscopic guidance failed to provide durable benefit. A subsequent CT-guided infraorbital nerve RFA resulted in marked pain reduction. The patient later developed localized recurrent dysesthesia, prompting a third CT-guided, navigation-assisted RFA with sustained improvement. At the last follow-up (8, 6, and 3 months after the first, second, and third RFAs, respectively), his visual analog scale pain score improved from 10 to 2, with approximately 80% reduction in pain flares and significant quality of life improvement. CT-guided infraorbital nerve RFA is a minimally invasive and effective option for refractory PTTN. Peripheral RFA, particularly when combined with advanced image guidance and potentially awake mapping, should be considered when central interventions fail or are contraindicated. https://thejns.org/doi/10.3171/CASE25553.

Peripheral nerve blocks provide highly effective postoperative analgesia for limb surgeries. But the complete resolution of the blockade is frequently followed by an abrupt and severe escalation in pain intensity that significantly exceeds baseline levels. This acute hyperalgesic response is termed ‘rebound pain’. Despite affecting nearly one half of all ambulatory orthopedic patients, standardized clinical protocols for its prevention remain unfound. The paper focuses on the pathophysiological mechanisms, patient-specific demographics, surgical risk factors, and pharmacological management strategies regarding severe rebound pain following peripheral nerve blockade. We investigated few studies focusing on the occurrence of rebound pain following peripheral nerve blocks for upper and lower limb surgeries. The debate included studies focusing particularly on pathophysiology, risk factors, and pharmacological adjuvants used, while central neuraxial techniques were excluded. Rebound pain represents a distinct physiological state driven by the silent peripheral accumulation of inflammatory mediators, coupled with a central nervous system unprepared for sudden nociceptive input. Risk stratification identifies younger patients, females, and individuals undergoing major osseous procedures as highly susceptible. Regarding pharmacological intervention, prioritizing maximum block duration does not necessarily improve the patient's functional recovery. Although perineural dexamethasone demonstrates a statistically significant prolongation of sensory effects, it fails to improve postoperative sleep quality or reduce peak rebound pain severity when compared to systemic intravenous administration. Perineural particulate steroids also carry theoretical risks of neurotoxicity. Mitigating the escalation of rebound pain requires shifting clinical focus away from maximizing sensory block duration toward optimizing the transitional analgesic phase. Current evidence supports the integration of preemptive, timed multimodal bridging analgesia combined with intravenous dexamethasone. Future research should prioritize functional patient outcomes, specifically sleep quality, over block duration

Objective: To evaluate the efficacy of intravenous analgesia versus intraoperative pectoral nerve block (PECs block) for postoperative pain management in patients having modified radical mastectomy (MRM). Methods: This randomized controlled trial was conducted at Akbar Niazi Teaching Hospital, Islamabad, from July to December 2025 (NCT07257874). PECs block (Group A, n=30) and intravenous analgesia (Group B, n=30) were the two groups into which 60 adult female patients (18–65 years) undergoing elective unilateral MRM were randomly assigned. Ten milliliters of 0.5% bupivacaine split between two fascial planes were used to administer PECs block. The Numeric Pain Rating Scale (NPRS) was used to measure postoperative pain intensity at 0, 6, 12, and 24 hours. Postoperative nausea and vomiting (PONV), time to first rescue analgesia, total opioid consumption within 24 hours, and patient satisfaction were secondary outcomes. Results: At every time point, Group A—NPRS scores were significantly lower than Group B (0 h: 2.1±0.8 vs. 3.4±1.1; 6 h: 2.6±0.9 vs. 4.1±1.2; 12 h: 2.9±0.8 vs. 4.0±1.0; 24 h: 2.4±0.7 vs. 3.5±0.9; p&lt;0.001). Group B consumed more opioids overall (28.7±6.2 mg) than Group A (mean 18.3±4.5 mg; p&lt;0.001). The PECs group experienced a significantly longer time to first rescue analgesia (412±85 minutes vs. 263±74 minutes; p&lt;0.001). PONV incidence was reduced in Group A (10%) versus Group B (33%). No block-related complications were observed. Group A had higher patient satisfaction scores (p&lt;0.01). Conclusion: When compared to intravenous analgesia alone, PECs block improves recovery profiles, reduces the need for opioids, and offers better postoperative analgesia in MRM patients. It ought to be incorporated into standard perioperative pain management techniques.