Pectoralis blocks

BLADEMDA

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Anyone doing pec1 or pec2 blocks for breast surgery? Pecs2 looks difficult. Pecs1 looks easy.

If any major medical center starts doing these blocks let me know. I'd consider going to visit just to learn the pecs2 block.
 

Oggg

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http://www.csen.com/pecs.pdf

I think they didn't show pictures of positioning and needle entry so people won't start doing it willy nilly.

The paper claims that nerve fibers from the cervical roots / brachial plexus contribute sensory innervation (and motor) to the breast, for certain procedures such as submuscular implants and breast expanders. Seems like a somewhat limited use. The article also talks about pecs 2 being useful for axillary clearance, which is more interesting.
 

BLADEMDA

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Blanco%20LO2908%20Fig.1%20pecs%20blk.jpg


Pec 1 Block. Limited Utility: Breast Implants and Breast Expanders
 

Oggg

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I will need to scan my pecs to see if I can find my serratus anterior... Have you tried it yet blade?
 

Uegis

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Thanks for posting about this as I heard it was being done in outpatient centers around where I'm at, but never done one myself. Any advantages over TPVB aside being farther away from the CNS/epidural space/interathecal space?
 

BLADEMDA

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Thanks for posting about this as I heard it was being done in outpatient centers around where I'm at, but never done one myself. Any advantages over TPVB aside being farther away from the CNS/epidural space/interathecal space?

TPVB is a great nerve block but risks include pneomothorax, epidural, spinal,vertebral artery puncture and sympathectomy.

Pectoralis Nerve Blocks should be devoid of these complications while providing excellent pain relief.
 
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