Reply to the article entitled "Ultrasound description of Pecs II (modified Pecs I): a novel approach to breast surgery".
نویسندگان
چکیده
OBJECTIVE The Pecs block (pectoral nerves block) is an easy and reliable superficial block inspired by the infraclavicular block approach and the transversus abdominis plane blocks. Once the pectoralis muscles are located under the clavicle the space between the two muscles is dissected to reach the lateral pectoral and the medial pectoral nerves. The main indications are breast expanders and subpectoral prosthesis where the distension of these muscles is extremely painful. MATERIAL AND METHODS A second version of the Pecs block is described, called "modified Pecs block" or Pecs block type II. This novel approach aims to block at least the pectoral nerves, the intercostobrachial, intercostals III-IV-V-VI and the long thoracic nerve. These nerves need to be blocked to provide complete analgesia during breast surgery, and it is an alternative or a rescue block if paravertebral blocks and thoracic epidurals failed. This block has been used in our unit in the past year for the Pecs I indications described, and in addition for, tumorectomies, wide excisions, and axillary clearances. RESULTS AND CONCLUSIONS The ultrasound sequence to perform this block is shown, together with simple X-ray dye images and gadolinium MRI images to understand the spread and pathways that can explain the benefit of this novel approach.
منابع مشابه
Ultrasound as a point-of-care tool for early detection of potential complications like pneumothorax associated with the pectoralis block
1. Blanco R, Fajardo M, Parras Maldonado T. Ultrasound description of pecs II (modified pecs I): A novel approach to breast surgery. Rev Esp Anestesiol Reanim 2012;59:470-5. 2. Mayes J, Davison E, Panahi P, Patten D, Eljelani F, Womack J, et al. An anatomical evaluation of the serratus plane block. Anesthesia 2016;71:1064-9. 3. Sarkisian AM, Bernie AM, Lee R. Principles of electrocautery based ...
متن کاملPectoral nerves I and II blocks in multimodal analgesia for breast cancer surgery: a randomized clinical trial.
BACKGROUND The pectoral nerves (Pecs) block types I and II are novel techniques to block the pectoral, intercostobrachial, third to sixth intercostals, and the long thoracic nerves. They may provide good analgesia during and after breast surgery. Our study aimed to compare prospectively the quality of analgesia after modified radical mastectomy surgery using general anesthesia and Pecs blocks v...
متن کاملEfficacy and Safety of Ketamine Added to Local Anesthetic in Modified Pectoral Block for Management of Postoperative Pain in Patients Undergoing Modified Radical Mastectomy.
BACKGROUND Breast surgery is an exceedingly common procedure with an increased incidence of acute and chronic pain. Pectoral nerve block is a novel peripheral nerve block alternative to neuro-axial and paravertebral blocks for ambulatory breast surgeries. OBJECTIVES This study aims to compare the analgesic efficacy and safety of modified Pecs block with ketamine plus bupivacaine versus bupiva...
متن کاملUnfavourable outcome after uneventful anaesthesia and surgery in a child with Hurler syndrome
1. Blanco R. The ‘PECS block’: A novel technique for providing analgesia after breast surgery. Anaesthesia 2011;66:847-8. 2. Bouzinac A, Brenier G, Dao M, Delbos A. Bilateral association of pecs I block and serratus plane block for postoperative analgesia after double modified radical mastectomy. Minerva Anestesiol 2015;81:589-90. How to cite this article: Tewari S, Dhiraaj S, Sachan V, Bhargav...
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ورودعنوان ژورنال:
- Revista espanola de anestesiologia y reanimacion
دوره 60 5 شماره
صفحات -
تاریخ انتشار 2012