Endocrine Abstracts

Purpose: Few studies have examined the clinical utility of ultrasonography-guided pectoralis nerve block II (PECS II) during wide flap dissection of SP robot-assisted transaxillary thyroidectomy (SP-RATT). This study presents preliminary results of a randomized controlled trial.

Methods: A total of 48 adult patients (aged ≥ 20 years) who underwent elective SP-RATT (including lobectomy) or total thyroidectomy from November 2022 to February 2023 at Seoul St. Mary’s Hospital (Seoul, Korea). The patients were divided into a block group (n =22) and no-block group (n =26). Pain was measured using a visual analog scale (VAS) at 4, 24, and discharge day after surgery, and the requirements for rescue painkillers in the post-anesthesia care unit and ward were recorded. The Korean version of quality of recovery-15 questionnaire (QoR-15) was used to assess quality of recovery after surgery.

Results: The demographic variables were comparable between the two groups. The block group had significantly lower VAS scores at 4 h postoperatively (3.0 ± 2.2 vs. 4.5 ± 2.3, P = 0.024). However, no significant group difference was observed after 24 h and at discharge day. The block group had lower VAS scores within 1 day of surgery than the no-block group, which experienced significant pain relief only after postoperative day 1. The block group required fewer painkillers in the post-anesthesia care unit than the no-block group. There was no statistically significant differences between the two groups in all items of the QoR-15K. However, the block group showed relatively higher scores in the pain item.

Conclusions: PECS II may serve as a new pain relief modality and valuable addition to the current multimodal analgesic strategy for patients undergoing SP-RATT.

Keywords: PECS II block, robotic surgery, transaxillary, thyroidectomy, visual analogue scale, randomized controlled trial