Modified PECS Block for Pain Control Following Mastectomy

  • The modified PECS block (PECS I and II):
    • Is a novel ultrasound-guided nerve block:
      • To target the medial pectoral nerve, lateral pectoral nerve, and lateral cutaneous branches of the intercostal nerves
  • Anatomic studies have shown significant variability in the location and branch distribution of the medial pectoral nerve:
    • While the lateral pectoral nerve reliably runs just lateral to the pectoral branch of the thoracoacromial artery between the pectoral major and pectoral minor muscles:
      • Offering a reliable target for ultrasound injection
  • References
    • Carstebsen LF, Jenstrup M, Lund J, Tranum-Jensen J. Pectoral block failure may be due to incomplete coverage of anatomical targets: a dissection Study. Reg Anesth Pain Med. 2018;43(8):844-848.
    • Woodworth GE, Ivie RM, Nelson SM, Walker CM, Maniker RB. Perioperative breast analgesia. Reg Anesth Pain Med. 2017;42(5):609-631.

#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #Miami #MountSinaiMedicalCenter

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