Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Feb 2025
Subpectoral plexus block to enhance surgical anesthesia produced by a multilevel thoracic paravertebral block for primary breast cancer surgery: a prospective randomized double-blind study.
The efficacy of a multilevel thoracic paravertebral block (6m-TPVB at T1-T6), as the sole anesthetic, for primary breast cancer surgery (PBCS) has been questioned. Current literature suggests that a significant number of patients may report pain during various stages of surgery, notably during the detachment of the breast base from the pectoralis major muscle and its fascia. Given that the pectoral muscles are innervated by nerves from the subpectoral plexus (C5-T1), which are not affected by a 6m-TPVB alone, we propose that an additional "subpectoral plexus block" (SPPB) may enhance the surgical anesthesia. ⋯ A SPPB enhances the surgical anesthesia produced by a 6m-TPVB for primary breast cancer surgery.