PECS II block: clarifications sought on nomenclature

To the Editor We read the article regarding the nomenclature for various regional anesthesia techniques and found it very useful. We greatly appreciate the efforts of the experts and respect their suggestions of nomenclatures for various regional anesthesia techniques. We strongly believe that nomenclatures suggested by the panel would certainly avoid confusion and wish to have clarifications on the nomenclature suggested for the PECS II block (pectoralis block II). To our knowledge, ‘PECS II’ is one of the commonly misinterpreted terms used in regional anesthesia parlance. Blanco et al described PECS II (modified PECS I) as a combination of two techniques which is inclusive of PECS I by default. Unfortunately, it is commonly misconstrued as a single technique, thereby erroneously describing it as ‘PECS I+PECS II’ by some authors as pointed out by Woodworth et al in their ‘thoughtprovoking’ review article on the anatomy and regional techniques of the breast. The experts (although 53% only) have agreed to the term ‘Pectoserratus plane block’ for PECS II. However, it requires clarification because the term ‘Interpectoral plane block’ suggested for PECS I has not been added to the proposed nomenclature for PECS II. We feel that it would have been better if the collective term ‘Interpectoral +Pectoserratus plane blocks’ was suggested for PECS II to make it more clear.