Endocrine Abstracts

Backgroud: Effective postoperative pain management with minimal opioid use is vital in robot-assisted transaxillary thyroidectomy (RATT), posing unique challenges in surgical flap-related pain control. Promising analgesic regional methods like the pectoral nerve II (PECS II) block are crucial for patients. To evaluate the efficacy of the PECS II block in reducing postoperative pain and opioid requirements and improving the quality of recovery in RATT.

Method: The study evaluated 90 patients aged 19-60 for elective RATT for a prospective randomized controlled trial. Seven patients were excluded due to medical conditions or high BMI. Ultimately, 83 patients were divided into two groups: 42 in the block group and 41 in the non-block group. The study was conducted in a controlled clinical setting at a tertiary medical center with an expert surgical team for RATT. The primary outcome measured was the degree of postoperative pain. Additionally, the number of opioid requirements and self-reported quality of recovery were assessed after RATT. Post-surgery VAS pain scores were measured at 1, 4, 24, and 48 hours, and rescue opioid usage was tracked. The Korean version of the Quality of Recovery-15 (QoR-15K) questionnaire was administered on discharge day.

Results: The block group reported lower postoperative pain scores at 1, 4, and 24 hours than the non-block group. Opioid use was higher in the non-block group, particularly in the PACU. The QoR-15K questionnaire revealed better pain management outcomes in the block group, while other recovery dimensions like physical comfort and emotional status were comparable across both groups.

Conclusions: The PECS II block can be a significant factor in enhancing the recovery experience for patients undergoing RATT, particularly in pain management. This approach could be a valuable addition to postoperative pain management strategies in RATT surgeries, aligning with the current medical emphasis on reducing opioid use and its associated risks.