Neuroanatomic Map for Nerve Block Design in Breast Surgery

We have read with interest a recent publication of Puentes-Gutiérrez and colleagues about post-breast surgery pain syndrome. Perioperative pain has been identified as one of the risk factors for post-breast surgery pain syndrome. There has been increasing literature regarding locoregional anesthesia techniques to cope with perioperative pain after breast surgery. In the PROSPECT guideline published in ۲۰۲۰, paravertebral block was recommended as the first choice with or without wound infiltration and pectoral nerve block was considered an alternative to paravertebral block.However, we would like to point out that paravertebral block, which acts on the intercostal nerves, is effective for pain from skin and the intercostal muscles. Pectoral nerve block, which acts on the lateral and medial pectoral nerves is effective for pain from pectoralis major andminor muscles. Paravertebral block and pectoral nerve block could work better together instead of replacing each other.

Keywords:

Breast Surgery