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. 2017 Apr;70(2):209-212.
doi: 10.4097/kjae.2017.70.2.209. Epub 2017 Jan 12.

Thoracic interfascial nerve block for breast surgery in a pregnant woman: a case report

Affiliations

Thoracic interfascial nerve block for breast surgery in a pregnant woman: a case report

Boohwi Hong et al. Korean J Anesthesiol. 2017 Apr.

Abstract

Regional anesthesia for non-obstetric surgery in parturients is a method to decrease patient and fetal risk during general anesthesia. Thoracic interfascial nerve block can be used as an analgesic technique for surgical procedures of the thorax. The Pecs II block is an interfascial block that targets not only the medial and lateral pectoral nerves, but also the lateral cutaneous branch of the intercostal nerve. Pecto-intercostal fascial block (PIFB) targets the anterior cutaneous branch of the intercostal nerve. The authors successfully performed a modified Pecs II block and PIFB without complications in a parturient who refused general anesthesia for breast surgery.

Keywords: Breast surgery; Parturient; Regional anesthesia.

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Figures

Fig. 1
Fig. 1. Ultrasound image of 2nd injection of modified Pecs II block. Pectoralis major (PM), pectoralis minor (Pm), serratus anterior muscle (SAM), and 2nd rib are demonstrated. Local anesthetics were injected underneath PM (small arrows). Arrowhead: needle.
Fig. 2
Fig. 2. Ultrasound image of pecto-intercostal fascial plane block. Pectoralis major (PM), 3rd and 4th costal cartilages are demonstrated. Needle was advanced in the cephalad direction while injecting local anesthetics underneath PM (small arrows), starting from 4th costal cartilage level. Arrowhead: needle.
Fig. 3
Fig. 3. Operation field. Wide excision performed with 5–6 cm incision.

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