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PECS BLOCK AND SERRATUS PLANE BLOCK UNDER ULTRASOUND- A NOVEL APPROACH TO TREAT PECTORALIS MAJOR SYNDROME-AN UNDER DIAGNOSED CAUSE FOR CHRONIC ANTERIOR CHEST WALL PAIN
ESRA Academy. Thottungal A. Sep 8, 2016; 138587
Topic: INTERVENTIONAL TECHNIQUES
Dr. Athmaja Thottungal
Dr. Athmaja Thottungal

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Abstract
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Background and Aims:

Pectoralis major syndrome is an under diagnosed cause of chronic anterior chest wall pain radiating to arm. It is normally seen in young atheletic individuals and it can be mistaken for cardiac pain if it is left sided. PEC blocks 1&2 along with serratus plane block are a well recognised blocks for breast surgery. This is a case series of 3 patients who presented with anterior chest wall pain who are successfully treated using this block.

Methods:

The block was performed as in plane approach under ultrasound guidance.30- 60 ml 0.125%-0.25% chirocaine and  40-80 mg depemedone  given depending up on unilateral or bilateral block needed.

Results:

Age Sex Clinical presentation Occupation Effect of PEC 2+ SPB.
28 M Left side-Anterior chest wall pain radiating to arm. Four previous admissions to A&E and investigated as cardiac pain Car mechanic and weight lifting 100% pain relief – Discharged back to community
43 F Bilateral chest wall pain. Treated before as costochondritis. No improvement. Ex military and national level swimmer 100% pain relief for 7 months.Improved function. Repeated injection and performed PRF after 9 months.
  45   F   Left side – anterior chest wall pain worse during lifting weight   Military chef   80-90% pain relief for 6 months. Repeated injection with functional improvement. Now investigated for shoulder problems.

Conclusions:

PECS 1,2 and serratus plane block are described for acute pain following breast surgery. It is a novel way to treat pectoralis major syndrome using these blocks.It is simple and safe block to do, but seems highly effective.

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