Pectoral Nerve Blocks

CA-2 ·

Case context, local only: Breast surgery, PECS I vs II, evidence for opioid reduction.
36Sources
6Kept
0Dropped

1 · Find evidence

PubMed query

Every result is a real PMID returned by NCBI. Nothing on this step is generated.

Ask OpenEvidence ↗

OpenEvidence opens in your own logged-in session with the question filled in. Nothing is fetched on your behalf — read it there, then add what you want to teach as a point below, citing the source it came from.

36 candidate papers

Ticked papers are the ones a deck may be built from. Unticking one needs a reason — the citation gate proves a paper exists, and nothing but you decides whether it should be taught. A tier badge appears where the paper’s publication type is known.

Same-day build

Build finished — 6 points drafted. The deck is in draft and needs your review. Open the draft deck done
PubMed query

Runs the tiered searches, drafts one point per included paper, runs the citation gate and builds a draft deck — the steps below, unattended. Same-day build — drafted locally (medgemma:27b), confirmed against each abstract. The deck still lands in draft: nothing here approves anything.

2 · Teaching points

Source

A point with no source will not survive the gate. That is the point of the gate.

6 points

For open thoracotomy surgery, this PROSPECT guideline recommends using erector spinae plane, rhomboid intercostal, or intercostal nerve blocks only as second-line regional analgesia when thoracic epidural analgesia or paravertebral blockade cannot be performed. PMID 41521792 kept
This randomised trial found that for patients undergoing uniportal thoracoscopic surgery, surgical intercostal nerve blocks with 30 ml of 0.5% ropivacaine significantly reduce 12-h morphine consumption and systemic local anesthetic absorption compared to ultrasound-guided erector spinae plane blocks. PMID 40537064 kept
This review found that nerve blocks can improve functional outcome in Maigne’s syndrome, where referred pain may originate from lesions or nerve impingements at any spinal joint between T9 and L2. PMID 39692376 kept
This meta-analysis found that PECS I or II blocks for breast cancer surgery decreased intraoperative opioid use by a mean difference of 5.28 and extended time to first rescue analgesia by 4.95 hours versus placebo. PMID 41632458 kept
This randomized trial found that administering i.v. esketamine at 0.3 mg/kg alongside either erector spinae or intercostal nerve blocks improves 24-hour quality of recovery scores in adults undergoing thoracoscopic lung resection. PMID 39172717 kept
This review identifies focused radiological guided anesthetic blocks as a diagnostic key for Maigne syndrome, finding that treatment yields the best outcomes when administered during the early disease stages. PMID 34151827 kept

Checks every citation against PubMed, the DOI resolver, or a live fetch. Points that do not resolve are dropped and shown to you with the reason — never quietly softened.

4 · Build the deck

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Decks

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5 · Question bank

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