An Anatomical Basis for Naming Plane Blocks of the Anteromedial Chest Wall

Chin, Ki Jinn

doi:10.1097/aap.0000000000000575

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…4,6 Other authors have previously highlighted the confusion resulting from this new nomenclature, thus suggesting that the techniques mentioned above are grouped under the common definition of 'parasternal intercostal plane blocks. ' 6 The PECS II block was developed by Blanco et al 7 as a modification of the previously described PECS I, which consists of an injection of local anesthetic between the pectoralis major and minor muscles, in order to reach the lateral pectoral and medial pectoral nerves. In the modified technique (PECS II), an additional dose of anesthetic is injected between the pectoralis minor muscle and the serratus muscle, or immediately above the underlying rib.…”

Section: Discussionmentioning

confidence: 99%

Anterior cutaneous nerve block for analgesia in anterior chest trauma: is the parasternal approach necessary?

Pietro¹,

Mascia²,

Bianco³

et al. 2020

Clin Exp Emerg Med

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In recent years, several techniques of regional anesthesia have been proposed to provide analgesia to the anterior thoracic cage; notably, most of these techniques require a parasternal approach. However, in this context, the potential role of a more common and well-established technique, namely the modified pectoral nerve block (known as PECS II block), has been poorly investigated. Here, we describe a case involving a patient with bilateral anterolateral multiple rib fractures associated with sternum fracture, who was successfully treated using bilateral PECS II blocks. Our experience indicates that the PECS II block can provide excellent analgesia in cases involving anterior rib and sternum fractures. Because it is easier to perform and may be safer than other parasternal techniques, the PECS II block should be considered when providing analgesia for traumatic injuries of the anterior thorax.

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Section: Discussionmentioning

confidence: 99%

Anterior cutaneous nerve block for analgesia in anterior chest trauma: is the parasternal approach necessary?

Pietro¹,

Mascia²,

Bianco³

et al. 2020

Clin Exp Emerg Med

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show abstract

“…The anterior branches of intercostal nerves can, therefore, be targeted in two fascial planes in the parasternal region: deep to pectoralis major and superficial to intercostal muscles (the superficial parasternal‐intercostal plane); and deep to intercostal muscles but superficial to transversus thoracis muscles (the deep parasternal‐intercostal plane; Fig. 4) [12].…”

Section: Anatomymentioning

confidence: 99%

“…deep to pectoralis major and superficial to intercostal muscles (the superficial parasternal-intercostal plane); and deep to intercostal muscles but superficial to transversus thoracis muscles (the deep parasternal-intercostal plane; Fig. 4) [12].…”

Section: Rhomboidmentioning

confidence: 99%

Ultrasound‐guided fascial plane blocks of the chest wall: a state‐of‐the‐art review

2021

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Summary Ultrasound‐guided fascial plane blocks of the chest wall are increasingly popular alternatives to established techniques such as thoracic epidural or paravertebral blockade, as they are simple to perform and have an appealing safety profile. Many different techniques have been described, which can be broadly categorised into anteromedial, anterolateral and posterior chest wall blocks. Understanding the relevant clinical anatomy is critical not only for block performance, but also to match block techniques appropriately with surgical procedures. The sensory innervation of tissues deep to the skin (e.g. muscles, ligaments and bone) can be overlooked, but is often a significant source of pain. The primary mechanism of action for these blocks is a conduction blockade of sensory afferents travelling in the targeted fascial planes, as well as of peripheral nociceptors in the surrounding tissues. A systemic action of absorbed local anaesthetic is plausible but unlikely to be a major contributor. The current evidence for their clinical applications indicates that certain chest wall techniques provide significant benefit in breast and thoracic surgery, similar to that provided by thoracic paravertebral blockade. Their role in trauma and cardiac surgery is evolving and holds great potential. Further avenues of research into these versatile techniques include: optimal local anaesthetic dosing strategies; high‐quality randomised controlled trials focusing on patient‐centred outcomes beyond acute pain; and comparative studies to determine which of the myriad blocks currently on offer should be core competencies in anaesthetic practice.

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Ultrasound-guided Serratus Anterior Plane Block, Along with Improved Parasternal Block, is Superior to Serratus Anterior Plane Block Alone in Relieving Pain for Rhinoplasty with Autologous Costal Cartilage

et al. 2022

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An Anatomical Basis for Naming Plane Blocks of the Anteromedial Chest Wall

Cited by 5 publications

References 7 publications

Anterior cutaneous nerve block for analgesia in anterior chest trauma: is the parasternal approach necessary?

Anterior cutaneous nerve block for analgesia in anterior chest trauma: is the parasternal approach necessary?

Ultrasound‐guided fascial plane blocks of the chest wall: a state‐of‐the‐art review

Ultrasound-guided Serratus Anterior Plane Block, Along with Improved Parasternal Block, is Superior to Serratus Anterior Plane Block Alone in Relieving Pain for Rhinoplasty with Autologous Costal Cartilage

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