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Peer-reviewedCC BY-NC 4.0Journal of Multidisciplinary Healthcare

Association of Ultrasound-Guided PECS II Block with Postoperative Pain Scores and Recovery Outcomes in Subpectoral Breast Augmentation: A Retrospective Cohort Study

  • Ergun Gunduz1
  • Ayse Nur Yeksan1
  • Ece Nur Apiliogullari2
  • Aysun Ozdemirkan1
  • Mehmet Sari3
  • Erdem Yağız Şahin1
  • Arif Emre Turkyilmaz1
  • Mehmet Ozdemir4
  • Kadir Berat Oyur4
  • Seza Apiliogullari1
4 affiliations
  1. 1Department of Anesthesiology, Istanbul Atlas University School of Medicine, Istanbul, Turkey
  2. 2St. Kliment Ohridski School of Medicine, Sofia, Bulgaria
  3. 3Department of Anesthesiology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
  4. 4Department of Aesthetic and Reconstructive Surgery, Istanbul Atlas University School of Medicine, Istanbul, Turkey
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Abstract

Purpose: Breast augmentation is one of the most frequently performed aesthetic surgical procedures. This study evaluated whether adding pectoral nerve II (PECS II) block to standard multimodal analgesia, as part of a multidisciplinary perioperative pain-management strategy, was associated with improved early postoperative outcomes in patients undergoing breast augmentation.

Patients and Methods: This retrospective study reviewed anesthesia records of 48 patients undergoing subpectoral breast augmentation between April 15, 2024, and November 1, 2025. Patients receiving an ultrasound-guided PECS II block in addition to standard multimodal analgesia were compared with patients receiving multimodal analgesia alone. The primary outcome was the highest post-anesthesia care unit (PACU) Visual Analog Scale score (VAS). Secondary outcomes included intraoperative remifentanil consumption, rescue meperidine use, PACU length of stay (PACU LOS), ward rescue analgesia, and block-related complications.

Results: A total of 48 patients were analyzed, including 27 in the PECS II block group and 21 in the control group. PACU VAS scores were lower in the PECS II block group than in controls (median [interquartile range]: 1 [0–2] vs 4 [3–6], p < 0.001). Intraoperative remifentanil consumption was lower in the PECS II block group (p = 0.009). VAS score ≥4 requiring protocol-driven rescue meperidine occurred in 71.4% of control patients but in none of the PECS II block patients (p < 0.001). PACU LOS was significantly shorter in the PECS II block group (p < 0.001). These associations persisted after multivariable adjustment. Ward rescue tramadol use did not differ significantly between groups (p = 0.186). No block-related complications were documented.

Conclusion: Ultrasound-guided PECS II block combined with multimodal analgesia was associated with improved postoperative analgesia, reduced opioid requirements, and shorter PACU LOS. These findings support its potential integration into multidisciplinary perioperative care after subpectoral breast augmentation. Further prospective studies are warranted to confirm these findings.

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Cite

BibTeXRIS
BibTeX
@article{gunduz2026association,
  title = {{Association of Ultrasound-Guided PECS II Block with Postoperative Pain Scores and Recovery Outcomes in Subpectoral Breast Augmentation: A Retrospective Cohort Study}},
  author = {Ergun Gunduz and Ayse Nur Yeksan and Ece Nur Apiliogullari and Aysun Ozdemirkan and Mehmet Sari and Erdem Yağız Şahin and Arif Emre Turkyilmaz and Mehmet Ozdemir and Kadir Berat Oyur and Seza Apiliogullari},
  journal = {Journal of Multidisciplinary Healthcare},
  year = {2026},
  month = oct,
  doi = {10.2147/jmdh.s649678},
  url = {https://doi.org/10.2147/jmdh.s649678},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Association of Ultrasound-Guided PECS II Block with Postoperative Pain Scores and Recovery Outcomes in Subpectoral Breast Augmentation: A Retrospective Cohort Study
AU  - Ergun Gunduz
AU  - Ayse Nur Yeksan
AU  - Ece Nur Apiliogullari
AU  - Aysun Ozdemirkan
AU  - Mehmet Sari
AU  - Erdem Yağız Şahin
AU  - Arif Emre Turkyilmaz
AU  - Mehmet Ozdemir
AU  - Kadir Berat Oyur
AU  - Seza Apiliogullari
PY  - 2026
DA  - 2026/10/28
JO  - Journal of Multidisciplinary Healthcare
DO  - 10.2147/jmdh.s649678
UR  - https://doi.org/10.2147/jmdh.s649678
AB  - Purpose: Breast augmentation is one of the most frequently performed aesthetic surgical procedures. This study evaluated whether adding pectoral nerve II (PECS II) block to standard multimodal analgesia, as part of a multidisciplinary perioperative pain-management strategy, was associated with improved early postoperative outcomes in patients undergoing breast augmentation.  Patients and Methods: This retrospective study reviewed anesthesia records of 48 patients undergoing subpectoral breast augmentation between April 15, 2024, and November 1, 2025. Patients receiving an ultrasound-guided PECS II block in addition to standard multimodal analgesia were compared with patients receiving multimodal analgesia alone. The primary outcome was the highest post-anesthesia care unit (PACU) Visual Analog Scale score (VAS). Secondary outcomes included intraoperative remifentanil consumption, rescue meperidine use, PACU length of stay (PACU LOS), ward rescue analgesia, and block-related complications.  Results: A total of 48 patients were analyzed, including 27 in the PECS II block group and 21 in the control group. PACU VAS scores were lower in the PECS II block group than in controls (median [interquartile range]: 1 [0–2] vs 4 [3–6], p < 0.001). Intraoperative remifentanil consumption was lower in the PECS II block group (p = 0.009). VAS score ≥4 requiring protocol-driven rescue meperidine occurred in 71.4% of control patients but in none of the PECS II block patients (p < 0.001). PACU LOS was significantly shorter in the PECS II block group (p < 0.001). These associations persisted after multivariable adjustment. Ward rescue tramadol use did not differ significantly between groups (p = 0.186). No block-related complications were documented.  Conclusion: Ultrasound-guided PECS II block combined with multimodal analgesia was associated with improved postoperative analgesia, reduced opioid requirements, and shorter PACU LOS. These findings support its potential integration into multidisciplinary perioperative care after subpectoral breast augmentation. Further prospective studies are warranted to confirm these findings.
SN  - 1178-2390
ER  -