A Qualitative Systematic Review of the Pectoral Nerves Block Type I and II

The pectoral nerves (Pecs) blocks are challenging the conventional approach of basing change in practice on scientific evidence. Indeed, several practitioners have already incorporated these blocks into their practice before conclusive evidence regarding their efficacy and safety has been published. This systematic literature review examines the analgesic efficacy of Pecs type I and II blocks for their current indications. We searched publications indexed by MEDLINE, EMBASE, Cochrane Library and Google Scholar from inception to October 2016 without publication type, status, language or publication period restrictions. In addition, we searched references and citations for other relevant studies. Results from our systematic literature search show encouraging and consistent evidence that the Pecs blocks produce effective analgesia, and reduce perioperative opioid consumption as compared to control groups without regional anesthesia, as well as other regional anesthesia techniques. Furthermore, the Pecs blocks provide favorable analgesic results in a wide range of indications including regional anesthesia and pain medicine technique. The absence of block-related complications reported in the literature may suggest that the Pecs blocks are easy to apply and safe for patients.