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Houston Methodist Sugar Land Hospital is first in Fort Bend to offer unique pain-control procedure for breast cancer surgery

Karl Nazareth, M.D., Brenda Murray, Michelle Shen, M.D.

Karl Nazareth, M.D., Brenda Murray, Michelle Shen, M.D.

Houston Methodist Sugar Land Hospital recently performed Fort Bend’s first PECS II block, a procedure to minimize the pain of breast cancer surgery.

PECS II is a relatively new pre-surgery approach to pain management. Using ultrasound technology, the anesthesiologist identifies the exact location of two major pectoral nerves and “blocks” them from pain with injections of a local anesthetic and a steroid. The procedure requires the anesthesiologist to place the medications at the precise depth between the layers of thoracic wall muscles to ensure the block is successful. Working together, the two medications numb the surgical area for 24 to 36 hours, reducing the patient’s discomfort during the most difficult part of recovery.

The procedure was performed on Brenda Murray of Missouri City by anesthesiologist Karl Nazareth, M.D., prior to a partial mastectomy and lymph node dissection/biopsy performed by Michelle Shen, M.D., and reconstructive work by Melissa Crosby, M.D. Murray was pain-free long after the surgery thanks to the new technique.

“I read that some patients have a lot of pain after their mastectomy surgery, especially when lymph nodes are involved,” says Murray. “But I didn’t have any pain at all, and I was back to my old self in no time. I even went to the grocery store three days after my surgery!”

Breast cancer surgery can be extremely painful, requiring a recovery period of days or even weeks when patients must rely on powerful opioids for pain management. With the PECS II pain procedure, however, patients typically require minimal pain medication and are much more comfortable in the days immediately following their procedure. Murray, however, did not take any pain medication following her surgery.

“Reducing or eliminating the use of narcotic or opioid pain medications is important because they often have side effects,” says Nazareth. “Some of those side effects can be quite serious, such as respiratory depression. Others – such as extreme drowsiness or constipation – can inhibit the healing process or add to the patient’s discomfort. With PECS II blocks, many patients need smaller doses of pain medication, if any at all, and they may get up and move about with less discomfort much sooner.”

Nazareth said the use of PECS II may reduce the need for an overnight hospital stay following some forms of breast cancer surgery.

“One of the main reasons patients stay overnight postoperatively is to ensure that we can control their pain,” he said. “The goal of the PECS II block, is to keep patients comfortable enough to return home.”

For more information about Houston Methodist Sugar Land Hospital, visit or call 281.274.7500 for a physician referral.

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