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Pectoral and Serratus Plane Blocks

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Regional Nerve Blocks in Anesthesia and Pain Therapy
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Abstract

The ultrasound-guided interpectoral, pectoserratus, and serratus anterior plane blocks are novel ultrasound-guided regional anesthesia techniques for superficial surgery of the anterolateral chest wall and axillary region. For these indications, the blocks have been swiftly introduced into clinical practice due to their relative simplicity, safety, and efficacy compared to the thoracic epidural and the thoracic paravertebral block.

This chapter provides an overview of the relevant clinical indications, anatomy, and sonoanatomy, a step-by-step guide for block performance, and practical tips on how to improve the success and avoid complications.

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Suggested Reading

  • Biswas A, Castanov V, Li Z, Perlas A, Kruisselbrink R, Agur A, et al. Serratus plane block: a cadaveric study to evaluate optimal injectate spread. Reg Anesth Pain Med. 2018;43(8):854–8.

    PubMed  Google Scholar 

  • Chong M, Berbenetz N, Kumar K, Lin C. The serratus plane block for postoperative analgesia in breast and thoracic surgery: a systematic review and meta-analysis. Reg Anesth Pain Med. 2019;44(12):1066–74.

    Google Scholar 

  • Grape S, El-Boghdadly K, Albrecht E. Analgesic efficacy of PECS vs paravertebral blocks after radical mastectomy: a systematic review, meta-analysis and trial sequential analysis. J Clin Anesth. 2020a;63:109745.

    Article  PubMed  Google Scholar 

  • Grape S, Jaunin E, El-Boghdadly K, Chan V, Albrecht E. Analgesic efficacy of PECS and serratus plane blocks after breast surgery: a systematic review, meta-analysis and trial sequential analysis. J Clin Anesth. 2020b;63:109744.

    Article  PubMed  Google Scholar 

  • Hussain N, Brull R, McCartney CJL, Wong P, Kumar N, Essandoh M, et al. Pectoralis-II myofascial block and analgesia in breast cancer surgery: a systematic review and meta-analysis. Anesthesiology. 2019;131(3):630–48.

    Article  PubMed  Google Scholar 

  • Jack JM, McLellan E, Versyck B, Englesakis MF, Chin KJ. The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review. Anaesthesia. 2020;75(10):1372–85.

    Article  CAS  PubMed  Google Scholar 

  • Jacobs A, Lemoine A, Joshi GP, Van de Velde M, Bonnet F. PROSPECT working group collaborators#. PROSPECT guideline for oncological breast surgery: a systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia. 2020;75(5):664–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kunigo T, Murouchi T, Yamamoto S, Yamakage M. Spread of injectate in ultrasound-guided serratus plane block: a cadaveric study. JA Clin Rep. 2018;4(1):10.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lovett-Carter D, Kendall MC, McCormick ZL, Suh EI, Cohen AD, Oliveira GSD. Pectoral nerve blocks and postoperative pain outcomes after mastectomy: a meta-analysis of randomized controlled trials. Reg Anesth Pain Med. 2019;44(10):923–8.

    Article  Google Scholar 

  • Versyck B, Groen G, Van Geffen G-J, Houwe PV, Bleys RL. The pecs anesthetic blockade: a correlation between magnetic resonance imaging, ultrasound imaging, reconstructed cross-sectional anatomy and cross-sectional histology. Clin Anat. 2019a;32(3):421–9.

    PubMed  Google Scholar 

  • Versyck B, van Geffen G-J, Chin K-J. Analgesic efficacy of the pecs II block: a systematic review and meta-analysis. Anaesthesia. 2019b;74(5):663–73.

    Article  CAS  PubMed  Google Scholar 

  • Zhao J, Han F, Yang Y, Li H, Li Z. Pectoral nerve block in anesthesia for modified radical mastectomy: a meta-analysis based on randomized controlled trials. Medicine. 2019;98(18):e15423.

    Article  PubMed  PubMed Central  Google Scholar 

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Versyck, B. (2022). Pectoral and Serratus Plane Blocks. In: Jankovic, D., Peng, P. (eds) Regional Nerve Blocks in Anesthesia and Pain Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-88727-8_31

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  • DOI: https://doi.org/10.1007/978-3-030-88727-8_31

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-88726-1

  • Online ISBN: 978-3-030-88727-8

  • eBook Packages: MedicineMedicine (R0)

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