THORACIC WALL NERVE BLOCK
Keywords:
Breast surgery; Regional anaesthesia; PECS I block; PECS II block; Serratus plane block; Post-opperative pain managementAbstract
Due to the widespread access to ultrasonography, regional anaesthesia has become a safe methode of post-oprative pain management. It can be performed not only in orthopedic surgeries, but also in thoracic wall surgeries. One of the most frequent chest wall operations are breast surgeries. Although thoracic epidural anaesthesia and paravertebral blockades continue to be relevant, increasing number of one-day procedures demands an easier alternative with a lower number of side effects. To meet these expectations, in 2011 R. Blanco introduced pectoral nerve blocks. In PECS I block local anaesthetic is injected between the pectoral major and minor muscles. PECS II block extends analgesia to the axilla and consists of PECS I block and a second injection of local anasthetic between the pectoral minor and serratus anterior muscles. Another effective methode of antero-lateral chest analgesia is serratus plane block, where LA is deposited in the interfascial plane above the serratus muscle. Above-mentioned procedures lead to a lower opioid consumption after chest surgery and, as a cosequence, a shorter stay in PACU.
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