ABSTRACT in the box belowObjectives : Breast surgery is frequently associated with severe post operative pain, both physically and psychologically. Thoracic epidural and Thoracic Paravertebral blocks are commonly performed for major breast surgeries. But for superficial breast surgeries, there is a need for reliable, simple and novel technique with the least possible complications and the best possible post operative analgesia. Anterior thoracic wall block namely Modified Pectoral Nerves Block (PECS II) is a good peripheral nerve block alternative.

METHODS : 40 patients undergoing elective superficial breast surgery – Fibroadenoma excision were randomly allocated into group L and group P. Both the groups were subjected to general anaesthesia with spontaneous ventilation with appropriate size laryngeal mask airway. Group L received 15 to 20 ml of local infiltration with 0.25% Bupivacaine and Group P received ultrasound guided PECSII block with 10ml of 0.25% Bupivacaine injected between the Pectoralis Major and Pectoralis Minor muscle and another 20ml of 0.25% Bupivacaine injected between Pectoralis Minor and Serratus Anterior. The following parameters were observed post operatively : Requirement of rescue analgesic in 24 hours, Pain scores and post operative nausea and vomiting.

RESULTS : Group P patients have better quality , prolonged duration of post operative analgesia with good patient satisfaction and lesser need for rescue analgesics. Statistical analysis will be discussed.

CONCLUSIONS : The nerves that are blocked in PECSII block include the lateral and medial pectoral nerves, the intercostobrachial nerve, T3 to T6 intercostal nerves and long thoracic nerve. The ultrasound sequence to perform the block will be shown and PECSII block is a novel peripheral nerve block technique for analgesia after breast surgeries.