Nerve blocks for Mastectomy Surgery QUALITY Improvement

The usage of nerve blocks for mastectomy surgery is discussed. Traditionally Opioids (e.g. Morphine, Hydromorphone, Oxycodone) have been the main component of perioperative analgesia. The opioid epidemic, and its unfriendly side effect profile have moved Anesthesia towards the "Multimodal Analgesia approach", meaning, we want to avoid using one type of drug too much, and instead use many with lower doses, helping us reduce side effects (For example, the use of Opioid Sparing medications such as Acetaminophen (Paracetamol), NSAIDs (e.g. Ketorolac, Diclofenac) and Ketamine. The latest trend, is the expansion of this Multimodal approach out of the "Medication-Only" realm, adding to it as well what is called "The Conduction Blockade". A conduction blockade is the inactivation of Nerves from even being allowed to bring generated algesia (the electrical generation of pain) to conscience. For this reason, they are called "The Nerve Blocks". Here I discuss recent high quality evidence on the incorporation of Nerve Blocks for Mastectomy surgery. Their contribution in this type of surgery is not great, but good, and combined with our previous pharmacological practice, this can at least enhance pain levels to a higher standard, without real significant risks in the hands of the experienced. Additionally, they help reduce side effects and improve patient satisfaction, making them less dependent on others as well. Other benefits are still being studied, but in the meantime, they potentially help avoid chronic pain and maybe could reduce cancer recurrence. Is it not worth it to be used in your opinion? Would you get one of those if you were the patient? What are the main current deterrents for this to be done in your opinion? Cited ESP video: "Erector Spinae Plane Block" Regional Anesthesiology and Acute Pain Medicine    • Erector Spinae Plane (ESP) Block