Pectoralis Minor Nerve Block versus Thoracic Epidural and Paravertebral Block in Perioperative Pain Control of Breast Surgery - Mini Review

Pectoralis minor blocks are still relatively new and require further evaluation, but they may have a place in perioperative pain management for the appropriate cases. To understand the pectoralis minor block, we need to discuss the anatomy of pectoral nerves. The lateral pectoral nerve originates from single root of lateral cord or upper and middle trunks (brachial plexus roots C5, C6, C7). Medial pectoral nerve (brachial plexus roots C8-T1) arises from anterior division of lower trunk or medial cord. Also, medial pectoral nerve may communicate with intercostobrachial nerve. The lateral pectoral nerve supplies the upper portion of pectoralis major muscle, tensor semivaginae articulation is humero-scapularis, pectoralis minim, sternoclavicularis, axillary arch, sternalis and infraclavicular muscles. Both lateral and medial pectoral nerves are closely related to thoracoacromial artery. The medial pectoral nerve supplies pectoralis quartus, sternalis muscles, chondrofascialis .