bupivacaine + epinephrine + clonidine (Wake Forest University Health Sciences)

The Pectoralis Nerve block (PECS block) is a regional anesthesia technique being evaluated by Wake Forest University Health Sciences for the management of postoperative pain following mastectomy and immediate breast reconstruction. In this specific clinical application, the block involves the ultrasound-guided injection of a local anesthetic solution—typically a combination of bupivacaine, epinephrine, and clonidine—into the fascial planes between the pectoralis major, pectoralis minor, and serratus anterior muscles. Bupivacaine acts as a sodium channel blocker to provide analgesia, epinephrine serves as a vasoconstrictor to prolong the block's duration and reduce systemic absorption, and clonidine acts as an alpha-2 adrenergic agonist to enhance the analgesic effect. The procedure aims to block the medial and lateral pectoral nerves, as well as the long thoracic and thoracodorsal nerves, to reduce opioid consumption and speed recovery.

Other names

Pectoralis Nerve blockPECS blockPECS I and II block