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Review paper

Pectoralis (PecS) nerve block 1 for port-a-cath removal and central venous catheter (CVC) replacement

By
Massimo Renzini Orcid logo ,
Massimo Renzini
Contact Massimo Renzini

Department of Pain Medicine Hospital S.M.M, Perugia, Perugia, Italy

Umberto Ripani ,
Umberto Ripani
Contact Umberto Ripani

Division of Clinic Anaesthesia, Department of Emergency Hospital Riuniti, Ancona, Italy

Luisa Golia ,
Luisa Golia

Department of Anaesthesia, Intensive Care and Pain Medicine, Hospital S.M.M., Perugia, Italy

Fulvio Nisi ,
Fulvio Nisi

Department of Anaesthesia, Intensive Care and Pain Medicine, Hospital S.M.M., Perugia, Italy

Fabio Gori
Fabio Gori

Department of Pain Medicine Hospital S.M.M, Perugia, Italy

Abstract

Aim
The use of PecS block 1 as perioperative analgesia for a central catheter removal-reimplantation combined procedure. Methods
A 55-year-old woman suffering from peritoneal metastases from gastric cancer needed to have a port-a-cath implanted for infection removed and to have a central venous catheter (CVC) implanted in the homolateral axillary vein due to patient's history of deep vein thrombosis of the right upper limb. We used PECS 1 block for perioperative analgesia.
Results
Compared to the traditional catheter implantation technique, reduction in the doses of local anaesthetics, shortening in the execution time, less intra-procedural bleeding, better patient's compliance, and no need for a rescue dose of local anaesthetic were observed.
Conclusion
The PEC1 block was effectively and safely used to remove an infected port-a-cath and to place a CVC on the same side. We hypothesize that it may be useful also for simple port-acath positioning.

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