Breast Block Description from

This Brief talk was delivered at the World Congress in Regional Anaesthesia in Paris in September 2023. Dr Pawa was Part of A Panel discussing the Anatomy and Block Choices relevant to Regional Anaesthesia for Breast Surgery.

[@asyahmi3732]

Yet another amazing, concise and complete explanation. Thank you for this #blockitlikeitshot

[@DrAmitPawa]

Glad it was helpful! Thank you so much

[@jxij99]

best lecture so far

[@DrAmitPawa]

Thank you so much 🙏🏽🙏🏽

[@tl854393]

Thank you for very detailed video. Do you often do PVB catheter for patient with breast and lung surgery? And can you share your tip about PVB catheter.

[@DrAmitPawa]

No catheter for breast surgery as not really required. For thoracic surgery, many of my colleagues will ask Surgeons to place catheters intra-operatively.
If placing under ultrasound guidance can do this in either transverse or Paramedian plane. Key is not to advance catheter more than 2-3cm past needle tip

[@user-sb8zr7xk3t]

Thanks so much. Amazing lecture

[@DrAmitPawa]

Thank You so Much 🙏

[@drandrewtan]

Are we thinking that ITP is superior to ESP (but inferior to PVB) when it comes to covering the ventral rami? In some hospitals, ESP block is standard for anterolateral rib fractures...and this is making me think that perhaps ESP is just not good enough for this purpose (although clinically patients seem to benefit from ESP)

[@DrAmitPawa]

I think you are now thinking along those lines that seems to be making sense to me. Logically, having a needle in the Retro-SCTL space would imply you are closer to the PVS anyway right? The issue is how reliable is a catheter there?
As long as we aim to get needle deep to the ES muscle fascia - it could be good enough

[@chriswong7075]

Do you have any issues with hypotension following bilateral PVBs?

[@DrAmitPawa]

I do quite a few Bilateral PVBs and as a general rule, I rarely see hypotension. This is even the case when adding in a Propofol/Remi GA techniique

[@MrGamal58e]

Was there a reason to change name from MTP to ITP?

[@DrAmitPawa]

The international consensus statement that I reference on the slide with all the blocks aimed to consolidate all the many variants of blocks in similar areas into universal names