American Society of Regional Anesthesia and Pain Medicine August 2016 - 44


muscles and serratus muscles along the 3rd and 4th ribs. If this is
possible, one can use this single scan to place local anesthetic in
all three planes with a single needle pass, starting with the deepest
plane, beneath the serratus muscle, and infiltrating as the needle is
withdrawn to finally deposit local anesthetic between the pectoralis
muscles.
Editor's Note: For description and demonstration of the block
techniques, follow the links to these two videos.
*	 PVBs: https://www.youtube.com/watch?v=vSbhqR5oIAs
*	 PEC blocks: https://www.youtube.com/
watch?v=YFWneF4pwOA
These videos were produced by the London Society of Regional
Anaesthesia (LSORA), featuring Drs Amit Pawa, PJ Bose, and
Mark Ibrahim.
REFERENCES
1.	 Schilling PL, Dimick JB, Birkmeyer JD. Prioritizing QI in general surgery. J Am
Coll Surg. 2008;207(5):698-704.
2.	 Gritsenko K, Khelemsky Y, Kaye AD, et al. Multimodal therapy in peri-operative
analgesia. Best Pract Res Clin Anaesthesiol. 2014;28(1):59-79.
3.	 Joshi GP, Beck DE, Emerson RH, et al. Defining new directions for more effective
management of surgical pain in the United States: highlights of the inaugural
Surgical Pain Congress. Am J Surg. 2014;80(3):219-228.
4.	 Richardson J, Lönnqvist PA, Naja Z. Bilateral thoracic paravertebral block:
potential and practice. Br J Anaesth. 2011;106(2):164-171.
5.	 Andersen KG, Kehlet H. Persistent pain after breast cancer treatment: a critical
review of risk factors and strategies for prevention. J Pain. 2011;12:725-746.
6.	 A. Macrae. Chronic post-surgical pain: 10 years. Br J Anaesth. 2008;101(1):77-
86.
7.	 Kairaluoma PM, Bachmann MS, Rosenberg PH, Pere PJ. Preincisional
paravertebral block reduces the prevalence of chronic pain after breast surgery.
Anesth Analg. 2006;103:703-708.

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8.	 Exadakylos AK, Buggy DJ, Moriarty DC, Mascha E, Sessler DI. Can anesthetic
technique for primary breast cancer surgery affect recurrence or metastasis?
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9.	 Sidiropoulou T, Buonomo O, Fabbi E, et al. A prospective comparison of
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paravertebral block after modified radical mastectomy. Anesth Analg.
2008;106(3):997-1001.
10.	 Heany A, Buggy DJ. Can anesthetic and analgesic techniques affect cancer
recurrence or metastasis? Br J Anaesth, 2012;109(suppl 1):i17-i28.
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12.	 Lönnqvist PA, MacKenzie J, Soni AK, Conacher ID. Paravertebral blockade:
failure rate and complications. Anaesthesia.1995;50:813-815.
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receiving antithrombotic or thrombolytic therapy: American Society of Regional
Anesthesia and Pain Medicine evidence-based guidelines. 3rd ed. Reg Anesth
Pain Med. 2010;35(1):64-101.
14.	 Eid HEA. Paravertebral block: an overview. Curr Anaesth Crit Care. 2009;20:65-
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15.	 Naja MZ, Ziade MF, El Rajab M, El Tayara K, Lönnqvist PA. Varying anatomical
injection points within the thoracic paravertebral space: effect on spread of
solution and nerve blockade. Anaesthesia. 2004;59:459-463.
16.	 R. Blanco. The 'Pecs block': a novel technique for providing analgesia after
breast surgery. Anaesthesia. 2011;66(9):847-8448.
17.	 Blanco R, Fajardo M, Maldonado TP. Ultrasound description of Pecs II (modified
Pecs I): a novel approach to breast surgery. Rev Esp Anestesiol Reanim.
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18.	 Perez MF, Miguel JG, Alfaro de la Torre P. A new approach to the pectoralis
block. Anaesthesia. 2013;68(4):430.
19.	 Blanco R, Parras T, McDonnell JG, Prats-Galino A. Serratus plane block: a novel
ultrasound-guided thoracic wall nerve block. Anaesthesia. 2013;68:1107-1113.
20.	 Auyong DB, Gonzales J, Benonis JG. The Houdini Clavicle: arm abduction and
needle insertion site adjustment improves needle visibility for the infraclavicular
nerve block. Reg Anesth Pain Med. 2010;35(4):403-404.

American Society of Regional Anesthesia and Pain Medicine
2016
https://www.youtube.com/watch?v=vSbhqR5oIAs https://www.youtube.com/watch?v=vSbhqR5oIAs https://www.youtube.com/watch?v=YFWneF4pwOA https://www.youtube.com/watch?v=YFWneF4pwOA https://www.youtube.com/watch?v=YFWneF4pwOA
Table of Contents for the Digital Edition of American Society of Regional Anesthesia and Pain Medicine August 2016
