PECS, Serratus Plane, Erector Spinae, and Paravertebral Blocks: A Comprehensive Review

Best Pract Res Clin Anaesthesiol. 2019 Dec;33(4):573-581. doi: 10.1016/j.bpa.2019.07.003. Epub 2019 Jul 17.


Thoracic planar blocks represent a novel and rapidly expanding facet of regional anesthesia. These recently described techniques represent the potential for excellent analgesia, enhanced technical safety profiles, and reduced physiological side effects versus traditional techniques in thoracic anesthesia. Regional techniques, particularly those described in this review, have potential implications for mitigation of surgical pathophysiological neurohumoral changes. In the present investigation, we describe the history, common indications, technique, and limitations of pectoral nerves (PECS), serratus plane, erector spinae plane, and thoracic paravertebral plane blocks. In summary, these techniques provide excellent analgesia and merit consideration in thoracic surgery.

Keywords: PECS; erector spinae; paravertebral blocks; serratus plane.

Publication types

  • Review

MeSH terms

  • Anesthesia, Conduction / methods*
  • Humans
  • Intermediate Back Muscles / diagnostic imaging*
  • Nerve Block / methods*
  • Pain Management / methods*
  • Pain, Postoperative / diagnostic imaging
  • Pain, Postoperative / prevention & control
  • Paraspinal Muscles / diagnostic imaging*
  • Thoracic Nerves / diagnostic imaging*
  • Thoracic Vertebrae / diagnostic imaging