Enhancing anterior shoulder analgesia with a modified PECS II block during shoulder arthroscopy under regional anesthesia alone: a translational anatomical and clinical feasibility study
Authors' conclusion
A modified PECS II block performed at the second to third intercostal spaces was associated with improved anterior analgesia and reduced sedation requirements during shoulder arthroscopy under RA alone.
Study context
- Population
- Adults undergoing arthroscopic shoulder surgery with anterior surgical steps under regional anesthesia (RA) alone
- Participants
- 46 adults
- Comparison
- Interscalene brachial (ISB)+superficial cervical plexus (SCP)+modified PECS II vs ISB+SCP
- Outcome
- Intraoperative anterior shoulder pain
Methodological detailscadaveric investigation and retrospective clinical analysis, cadaveric dissection
- Cadaveric investigation and retrospective clinical analysis
- Cadaveric dissection
Main finding
As reported in the abstract
P < 0.001
- Modified PECS block the only independent predictor of pain reduction
- 0.0467 (aOR; 95% CI 0.0057 to 0.38)
Secondary outcomes
Complete RA without supplemental sedation
P < 0.001
| Outcome | P value |
|---|---|
| Sedation for pain | P < 0.001 |
Cadaveric anatomy
- Anterior sensory branches of the intercostobrachial nerve coursing toward the deltopectoral region, occasional anastomoses to the medial pectoral nerve
Original publication
Enhancing anterior shoulder analgesia with a modified PECS II block during shoulder arthroscopy under regional anesthesia alone: a translational anatomical and clinical feasibility study. Reg Anesth Pain Med. Published 11 February 2026. doi:10.
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