A fascial plane block that provides effective long-lasting anesthesia for breast and anterior chest surgery. Under direct ultrasound guidance using sterile technique, long-acting anesthetic is placed between pectoralis minor and major muscles moving from lateral to medial direction.
we're doing an open biceps tenodesis and what we found is a pec one block works really well when we have our open biceps tendonitis and try to get right up here between the pec major and minor in this area right up in here so you can come from superior to inferior or inferior to superior and in this case looks like it's going to be easier to do coming from inferior to superior you see the subclavian artery down here kind of hard to see the separation between the pec major and the pec minor there but i think we got it maybe if i go a little more medial right there there we go all right sting right here a little number shot here it's gonna sting one two three a little burn right here that a boy all right so we're going to introduce here we'll come right through the pec major muscle come a little shallower it's kind of a thick pec major here so here we come and as soon as we get through the pec major and the opening between the major and minor right there probably give us a couple and see if we're in the right space perfect okay give me uh three more let's see we're going to open up this area right here beautiful okay try to come out a little more lateral even and superior okay give me five there all right so what we've done is open you can see we've opened up the space here between the pec major and pec minor it's a little deeper here you can see the minor down here and the subclavian artery we've opened this space up with local and what we think is happening is this local is spreading laterally and getting to the intercostal brachial nerve to get this this pain down here with this incision for the open biceps tendonitis which is under the arm in the axilla basically so that's our approach that's a nice place to use the claria simple ultrasound you get a good image and so it's really portable we can move around and do this anywhere at any time that's a peck one block with the uh clarius and an ipad for your ultrasound image
