M A Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 1 3 9
T
horacic epidurals and paravertebral blocks have long been the
gold standards for breast surgery anesthesia, but both are asso-
ciated with significant challenges. Thoracic epidurals aren't
really suited to the outpatient realm, and paravertebral blocks, the
most widely used technique of regional anesthesia for breast surgeries,
require a high degree of skill and confidence, due to the risk of iatro-
genic pneumothora or inadvertent entry of a needle into the vertebral
canal with consequent spinal cord trauma.
But regional blocks have some distinct advantages in this area. For
Anesthesia Alert
Mike MacKinnon, CRNA
Mike
MacKinnon,
CRNA
• ULTRASOUND GUIDANCE Start by placing the ultrasound probe inferior to the clavicle in a paramedian orientation, to identify the axillary artery, vein
and pectoralis major and minor. Once you identify the 3rd rib, rotate the probe 90 degrees and slide it toward the lateral aspect of the chest wall.
Pectoral Nerves Blocks for Breast Surgery
These ultrasound-guided blocks are reliable and easy to master.