Bloc interpectoral avec mise en place d’un cathéter pour analgésie postopératoire après chirurgie mammaire

Pectoral nerves I block is associated with a significant motor blockade with no dermatomal sensory changes: a prospective volunteer randomized-controlled double-blind study

“…[4][5][6][7] Very few studies or case reports have been published for PECS I block alone. 20,21 One must also take into consideration that most of these studies might not have been using a PECS I block for the appropriate type of surgery as pectoral nerve blockade may not be of major importance in mastectomies where mammary tissue receives the majority of trauma and not the pectoralis muscles themselves. 2 Still, the favourable use of PECS I in breast cancer surgery has been described in the retrospective study by Abdallah et al 22 who showed comparable efficacy between the PECS I and the serratus anterior plane block.…”

“…Résultats La force moyenne de l'adducteur (écart-type [ET]) évaluée avant le bloc était de 119,4 (20,7) Newtons (N). Après le bloc PECS I avec la bupivacaïne, la force moyenne (ET) était de 54,2 (16,3) N comparée à 116,0 (30,4) N dans le groupe placebo (différence des moyennes 61,8 N; intervalle de confiance à 95% [IC] : 27,8 à 95,8; P = 0,005), démontrant une baisse de 54,6% (IC à 95% : 43,6 à 65,6%) de la force d'adduction.…”

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

“…The subsequent year, a modified version of this approach named the Pecs II block was described for axillary dissections by aiming to increase the number of nerves affected to include the intercostobrachial, intercostal 3-6, and long thoracic nerves [147]. Variant approaches have been published [148,149], including the insertion of a catheter to allow a postoperative perineural local anesthetic infusion [150]. The technique has been described primarily for breast augmentation [148,149], with one retrospective series reporting decreased pain scores at 8 hours when a pectoralis block was added to a paravertebral block compared with historic controls with solely a paravertebral block [151].…”

Bloc interpectoral et chirurgie mammaire : un simple bloc intercostal par diffusion ?

“…Les cas rapporté s par Wallaert et al [1] concernant l'utilisation, avec succè s, du bloc interpectoral dans la chirurgie du sein nous amè nent à vous faire part de quelques ré flexions pour nous aider à juger de la place ré elle de cette technique dans cette indication.…”