Tips for a PEC II Block

The PEC II block anesthetizes the lateral and medial pectoral nerves, the anterior lateral cutaneous branches of the intercostal nerves, and the intercostobrachialis, providing analgesia for extensive breast surgery, thoracic wall procedures, and sentinel node excision.

Here are our 3 go-to tips to perform a PEC II block

1. Place the transducer in a sagittal orientation below the midline of the clavicle.
2. From the PEC I position, slide the transducer laterally to identify the 4th and 5th ribs and the serratus anterior muscle.
3. Insert the needle in-plane, from anterior to posterior, through the pectoralis major muscle and inject local anesthetic in two fascial planes.
   – 10 mL between the pectoralis major and minor muscles (PEC I).
   – 15-20 mL between the pectoralis major and serratus anterior muscles (PEC II). 

Watch the video below to get a better picture of the process and see how the NYSORA Nerve Blocks App brings these instructions to life: 

For more tips like these and the complete guide to the 60 most frequently used nerve blocks, download the Nerve Blocks App HERE. Don’t miss the chance to get the bestselling NYSORA Nerve Blocks App also in book format – the perfect study companion with the Nerve Blocks app!