OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Emilia Guasch and Manuel WenkBreast surgery and peripheral blocks. Is it worth it?Schwemmer, UlrichAuthor Information Department of Anesthesiology and Intensive Care Medicine, Kliniken des Landkreises Neumarkt i.d. Opf, Neumarkt, Germany Correspondence to Ulrich Schwemmer, Klinik für Anästhesiologie und Intensivmedizin, Kliniken des Landkreises Neumarkt i.d. Opf., Nürnberger Str. 12, D-92318 Neumarkt, Germany. Tel: +49 9181 420 3860; e-mail: email@example.com Current Opinion in Anaesthesiology: June 2020 - Volume 33 - Issue 3 - p 311-315 doi: 10.1097/ACO.0000000000000863 Buy Metrics Abstract Purpose of review The objective of this review is to identify the potential of peripheral nerve blocks established over the last years for perioperative pain management in breast surgery. These new blocks will be discussed with respect to their clinical effect and necessity. Recent findings After case reports and cadaver studies for the Pecs block and its variations sufficient clinical data from randomized controlled trial (RCT) and meta-analyses exist now. The modified Pecs block or Pecs II leads to a reduction of postoperative 24-h opioid consumption. The recently invented Erector spine block addresses the intercostal nerves. The benefits in analgesia of this approach were tested in few RCTs and showed superiority to the control group in terms of requested postoperative morphine. Most studies showed low intraoperative opioid doses and no study more than low to moderate postoperative pain scores. Summary Taking the pain levels after breast surgery into account, the request of additional nerve blocks has to be pondered against the potential risks and resource requirement. To reduce or avoid intraoperative or postoperative opioids, an ultrasound-guided Pecs II block proves to be the best option for perioperative pain relief. Copyright © 2020 YEAR Wolters Kluwer Health, Inc. All rights reserved.