Ultrasound-Guided Pectoralis Block for Incision and Drainage of Chest Wall Abscess in the Emergency Department

Incision and drainage (I&D) of cutaneous abscesses is painful and typically requires local anesthesia or procedural sedation. Ultrasound-guided regional nerve blocks have occasionally been utilized in the emergency department (ED) to provide anesthesia for I&D of larger abscesses to avoid procedural sedation and minimize the need for larger doses of opioids.

We describe the case of a 45-year-old man with recurrent chest wall abscesses that presented to the ED for I&D. He underwent a combined pectoralis (PECS) nerve block I and II which provided considerable pain relief and facilitated an uncomplicated I&D. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: As part of multimodal analgesia, the PECS blocks may allow emergency physicians to provide safe and effective cutaneous anesthesia for ED procedures involving the anterolateral chest wall, such as incision and drainage of abscesses on the chest wall, breast, and axilla.