Pectoralis block for breast surgery: A surgical concern?

A randomised controlled study of the post-operative analgesic efficacy of ultrasound-guided pectoral nerve block in the first 24 h after modified radical mastectomy

“…In a study, it was reported that interference of injectate reduces the efficacy of the electrocautery. [ 16 ] In this study, no such incidence was reported probably because the time of Pecs block to surgical incision was more than 20 min and this interval may have altered local anaesthetic absorption from the surgical field.…”

Intraoperative pectoral nerve block (Pec) for breast cancer surgery: A randomized controlled trial

“…Inability to use the electrocautery during surgical dissection was due to local anesthetic spread along the tissue planes. [ 6 ] In the presence of tissue edema, tissue conductance increases, so causes lower resistance, resulting in reduced electrocautery efficacy.…”

Newer regional analgesia interventions (fascial plane blocks) for breast surgeries: Review of literature

“…Use of these blocks may have several limitations such as failure of block in altered anatomy[ 29 ] or hindrance to surgical electrocautery. [ 30 ] In cases where the sonoanatomy of the chest wall may be altered, for example, post-mastectomy contractures of the chest wall, ultrasound-guided interfascial block-like PECS may not be feasible. Alternate techniques of analgesia such as supraclavicular brachial plexus block may be used to block the median and lateral pectoral nerves.…”

“…These may be overcome using harmonic scalpel or bipolar cautery. [ 30 ] In addition, concerns related to interference of surgical dissection due to deposition of drugs in the fascial plane needs to be studied further. Such complications should be kept in mind and reported in detail in future studies to further fine-tune techniques of block and related changes in surgical technique.…”