Practical Review of Abdominal and Breast Regional Analgesia for Plastic Surgeons

Evidence and Techniques

Hassan ElHawary, MD, MSc; Girish P. Joshi, MBBS, MD, FFARCSI; Jeffrey E. Janis, MD, FACS


Plast Reconstr Surg Glob Open. 2020;8(12):e3224 

In This Article


A systematic search of the PUBMED, EMBASE, and Cochrane databases was performed using a combination of keywords and MeSH terms, including "transversus abdominis block," "pectoral nerve block," "serratus anterior block," "erector spinae plane block," "interfascial plane block," AND "plastic surgery." All studies from January 1980 to March 2020 were considered. Inclusion criteria comprised randomized controlled trials, prospective and retrospective cohort studies, as well case series that discussed regional blocks in plastic surgery. Studies assessing the effect of blocks on mastectomies were included, given the significant overlapping relevance to plastic surgery breast procedures. Exclusion criteria included the use of regional analgesia techniques in non-plastic surgery procedures with no overlapping relevance. Studies that included more than 1 block in a group of participants without sub-analyses were excluded. Moreover, clinical studies with less than 10 participants were also excluded. A qualitative analysis of all the included studies was preformed, and recommendations regarding indications, efficacy, and safety were presented.