PECS Block — FRCA Final MCQ

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ModerateRegional AnaesthesiaPECS BlockFRCA Final

A 40-year-old woman undergoing mastectomy receives an ultrasound-guided PECS II block. After the interpectoral injection has been performed, which tissue plane is targeted by the second, deeper injection?

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Correct answer: A — Between pectoralis minor and serratus anterior

The correct answer is A. PECS II comprises two fascial-plane injections. The first is the interpectoral component between pectoralis major and pectoralis minor, corresponding to PECS I and targeting the pectoral nerves. The defining second, deeper component is deposited between pectoralis minor and serratus anterior—the pectoserratus plane—to provide wider lateral chest-wall and axillary analgesia. Option E is therefore part of the complete PECS II technique but is not the second injection requested. Option D is deep to serratus anterior and represents a deep serratus anterior plane approach. Option C is superficial to serratus anterior and corresponds to a superficial serratus anterior plane approach. Option B describes superficial infiltration rather than a PECS block.

Reference: Tariq HM et al. The Pectoral (PECS) Regional Block: A Scoping Review. 2023. https://pubmed.ncbi.nlm.nih.gov/37933365/