Regional anesthesia for pectoralis major tendon repair

  • Heather Y. Z. Ting
  • Joseph W. Bergman
  • Ban C. H. TsuiEmail author

To the Editor,

Regional anesthesia is used commonly as a sole means for surgical anesthesia and is also used widely for postoperative analgesia. Occasionally, however, regional anesthesia is used to inhibit motor function following surgery. For a recent case of pectoral tendon repair, our surgical colleagues requested brief motor and prolonged sensory anesthesia in the repaired area to prevent any inadvertent damage from movement immediately following surgery and to manage pain. There is a shortage of literature describing regional anesthesia techniques that address both the overlying cutaneous innervation and the motor innervation of the pectoralis muscle for pectoral tendon repair surgery. Here, with the patient’s consent, we present a case of pectoralis major repair in which a regional technique was used for successful management of motor function to reduce the risk of rupture of a freshly repaired tendon due to excessive movement during emergence.

A 52-yr-old male presented with a...


Brachial Plexus Motor Block Tendon Repair Interscalene Block Pectoral Nerve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank Jenkin Tsui (Department of Anesthesiology and Pain Medicine, University of Alberta) for granting permission to use the original illustration. Dr. Tsui is supported by a Clinical Scholar Award from the Alberta Heritage Foundation for Medical Research (AHFMR). Dr Tsui’s research is supported by the Canadian Anesthesia Research Foundation.

Conflict of interest

None declared.


  1. 1.
    Tsui BC, Lou L. Learning the ‘traceback’ approach for interscalene block. Anaesthesia 2014; 69: 83-5.PubMedCrossRefGoogle Scholar
  2. 2.
    Ip VH, Tsui BC. Lower interscalene approach for elbow surgery. Can J Anesth 2013; 60: 600-1.PubMedCrossRefGoogle Scholar
  3. 3.
    Porzionato A, Macchi V, Stecco C, Loukas M, Tubbs RS, De Caro R. Surgical anatomy of the pectoral nerves and the pectoral musculature. Clin Anat 2012; 25: 559-75.PubMedCrossRefGoogle Scholar
  4. 4.
    Merolla G, Paladini P, Campi F, Porcellini G. Pectoralis major tendon rupture. Surgical procedures review. Muscles Ligaments Tendons J 2012; 2: 96-103.Google Scholar
  5. 5.
    Lanz E, Theiss D, Jankovic D. The extent of blockade following various techniques of brachial plexus block. Anesth Analg 1983; 62: 55-8.PubMedGoogle Scholar
  6. 6.
    Winnie AP. Interscalene brachial plexus block. Anesth Analg 1970; 49: 455-66.PubMedCrossRefGoogle Scholar

Copyright information

© Canadian Anesthesiologists' Society 2014

Authors and Affiliations

  • Heather Y. Z. Ting
    • 1
  • Joseph W. Bergman
    • 2
    • 3
  • Ban C. H. Tsui
    • 1
    Email author
  1. 1.Department of Anesthesiology and Pain MedicineUniversity of AlbertaEdmontonCanada
  2. 2.Division of Orthopedic SurgeryUniversity of AlbertaEdmontonCanada
  3. 3.Sturgeon Community HospitalABCanada

Personalised recommendations