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Novel use of a continuous PECS II block for mastitis pain treatment
  1. Enrica Delfino1,
  2. Roberta Netto1,
  3. Alessandra Cena1,
  4. Lorella Faraoni2,
  5. Daniela Gogna1 and
  6. Luca Montagnani1
  1. 1 Department of Anesthesia, Intensive Care, and Out-of-Hospital Emergency, AUSL Aosta, Aosta, Italy
  2. 2 Poison Control and Toxicology Center, ASST Papa Giovanni XXIII, Bergamo, Lombardia, Italy
  1. Correspondence to Dr Enrica Delfino, Department of Anesthesia, Intensive Care, and Out-of-Hospital Emergency, AUSL Aosta, Aosta 11100, Italy; delfinoenrica1{at}


Nipple trauma and mastitis (an inflammatory condition of the breast) are common causes of intense pain during breast feeding. Although such pain normally results in early weaning, which has negative impacts on both maternal and child health, little is understood about the treatment of pain experienced during breast feeding. Here, we describe our experience with a woman who presented at 26 days post partum with a 15-day history of deep nipple wounds that caused bilateral mastitis and excruciating pain that radiated dorsally. Antibiotic, antifungal and non-pharmacological therapies were unsuccessful, and she wished to suspend breast feeding. We performed a bilateral pectoralis nerve block type II and inserted intrafascial catheters between the pectoralis minor and serratus muscles for continuous analgesia. Following block completion, the pain in her torso resolved immediately. The local anesthetic infusion continued for 40 hours and the patient had sustained analgesia with rapid healing of nipple lesions and her breast feeding commencing at 36 hours after block placement.

  • continuous peripheral techniques
  • interventional pain management
  • obstetrics

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval This study was deemed exempt from the requirement for institutional ethical approval. The patient has provided consent for the publication of the case details.

  • Provenance and peer review Not commissioned; externally peer reviewed.