PECS I block for postoperative analgesia in patients undergoing breast augmentation surgery: a randomized double-blind placebo-controlled study

Intraoperative pectoral block versus thoracic paravertebral block for postoperative analgesia after breast cancer surgery: A randomized controlled trial

“…These results should not be surprising because PECS I block only numbs the pectoral muscles and fascia commonly affected during major surgery, but its effect on the breast parenchyma and the overlying dermatome is controversial. Classical single interpectoral injection of PECS I block may not block the medial pectoral nerve or all of its perforating branches 30 . With this in mind, different pectoral nerve blocks were studied in a cadaveric study 31 .…”

“…Classical single interpectoral injection of PECS I block may not block the medial pectoral nerve or all of its perforating branches. 30 With this in mind, different pectoral nerve blocks were studied in a cadaveric study. 31 The technique consists of a triple injection to block the lateral and medial pectoral nerves and their branches as completely as possible.…”

Thoracic fascial planes blocks in operative bed of modified radical mastectomy and their role in alleviating post-mastectomy pain: a prospective randomized study

“…3 Although several studies emphasized the analgesic efficacy of PECS II and SAP blocks after breast surgeries, some criticized the analgesic effect of PECS I, because the PECS I blocks selectively the lateral pectoral nerve and some perforating branches of medial pectoral nerve which are motor nerves. 16,17 The analgesic effect of PECS I is attributed to relieve the pain resultant from pectoral muscles trauma and spasm. 18 Finally, understanding thoracic wall and breast innervation is crucial to achieve proper analgesia to entire breast tissue after MRM.…”

Perspectives on Pecs I block in breast surgeries

“…I read the article about the clinical investigation of Pecs I block in breast augmentation surgeries, published recently, with profound interest. 1 I greatly appreciate the authors for the wonderful clinical investigation of Pecs I block in breast augmentation procedures. I wish to present my perspectives on that article which I believe would make more clarity on this topic.…”

“…They have also concluded that the role of Pecs I block should be “reconsidered” in breast augmentation surgery as well as in breast cancer procedures. 1 However, I strongly believe that Pecs I (pectoral component of Pecs II) block has definitely some role to play in postoperative pain relief in breast surgeries, particularly in breast augmentation procedures. This is because of the fact that the pectoral nerves do play a role at least in the “Myofascial” aspect of the pain, although they do not innervate the skin and subcutaneous tissues of the breast.…”