Potential Complication of a Pectoral Nerve Block

  • The pectoral branch of the thoraco-acromial artery can be encountered during a pectoral nerve block, or pecs block [not thoracic paravertebral nerve block (PVBs)]:
    • As it is consistently located adjacent to the lateral pectoral nerve
  • The pecs block is a field block:
    • In which local anesthetic is injected in the interfacial plane between the pectoralis major and minor muscles.
  • In addition to the pecs II block:
    • A modification blocking the long thoracic and thoracodorsal nerves:
      • The pecs block is an alternative to the thoracic paravertebral block in a multimodal pain management technique:
        • Intrathecal spread, intra-pleural injection and pneumothorax, bradycardia, and hypotension resulting from a sympathectomy in the neuraxis:
          • Are all known complications of thoracic paravertebral blocks
  • References:
    • Blanco R. The ‘pecs block’: a novel technique for providing analgesia after breast surgery. Anesthesia 2011; 66:847–8.
    • S. Kulhari, et al. Efficacy of pectoral nerve block versus thoracic paravertebral block for postoperative analgesia after radical mastectomy: a randomized controlled trial. BrJ Anaesth. 2016;117(3):382–386.

#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #BreastCancer #PainManagement #Mastectomy #PectoralNerveBlock #Miami #Mexico #MountSinaiMedicalCenter

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