Approach and Troubleshooting to Thoracic Blocks

Peripheral nerve blocks for thoracic region are used for operative anaesthesia and/or postoperative analgesia for a variety of surgeries of the chest. Introduction and acceptance of these blocks has helped in lowering the opioid consumption to a large extent. This chapter will discuss the relevant anatomy, clinical applications, techniques and drugs used for these blocks and complications common to all nerve blocks. The blocks covered in this chapter include Pectoral Nerve Block, Serratus Anterior Plane Nerve Block and Transversus Thoracic Muscle Plane block. These blocks have stolen the limelight due to their less invasive nature in comparison with paravertebral blocks. These techniques are simple for the clinician to perform and require little or no sedation in the pre-operative holding area. Thoracic Blocks have found their way into a lot of clinically relevant applications like cessation of postoperative pain following pacemaker insertion, fractured ribs, superficial mastectomy, breast reconstruction, ICD insertion.