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Front. Surg. | doi: 10.3389/fsurg.2019.00064

Pectoralis Plane Block for Pacemaker Insertion: A Successful Primary Anesthetic

  • 1University of Miami Hospital, United States

Effective anesthesia, analgesia and hemodynamic stability is important to maintain during pacemaker implantation surgery, especially in the elderly population and patients with compromised cardiac function. As a strategy to avoid the need for intravenous (IV) anesthetics, peripheral nerve block techniques may be used in these specific cases. We report a case of successful pacemaker implantation surgery in a patient with severe Aortic Stenosis (AS) and Sick Sinus Syndrome (SSS) using unilateral pectoralis plane block for surgical anesthesia. Since general anesthesia was considered risky, monitored anesthesia care utilizing peripheral nerve block was planned. A single shot left side pectoralis plane block (PECS II) was done under ultrasound guidance injecting a total of 20 mL of 0.5% Ropivacaine with 1% Lidocaine. No sedation was needed. The patient tolerated the procedure with no significant hemodynamic changes. Patient did not require opioids postoperative and was discharged home in stable condition the next day. This case highlights that PECS block can also provide effective surgical anesthesia for relatively long procedures avoiding the risk of complications associated with IV anesthesia in high risk cardiovascular patients. Additionally, these blocks can provide an opioid sparing option for postoperative management in pacemaker implantation surgeries.

Keywords: pectoralis block, pacemaker, regional anesthesia, Ultrasound guided, Analgesia

Received: 10 Jul 2019; Accepted: 04 Nov 2019.

Copyright: © 2019 Mavarez, Ripat and Suarez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
MD. Ana C. Mavarez, University of Miami Hospital, Miami, United States,
MD. Maria R. Suarez, University of Miami Hospital, Miami, United States,