The dynamic “Tsunami‐sign” to replace the “double‐v sign” for an effective interfascial block? A case of interfascial block in breast lymphoma

In breast surgery, radical procedures such as mastectomies, previously performed only under general anesthesia, are now performed with a patient sedated by wall blocks. Wall blocks are also called fascial blocks and consist in the injection and propagation of local anesthetic through the fascial district where vascular structures and nerves run along; this allows the spread of anesthetic even far from the injection site.
The aim of the study was to point out the importance of the dynamic progression of local anesthesia in the interpectoral fascia. The fascial block was difficult to execute, because the neoformation also infiltrated the fascial plan. In this way, we overcame the obstacle with the needle and observed the progress of the local anesthetic so that we had good anesthetic coverage. This study is limited by the fact that it is only one patient, but the concept of dynamic progression of local anesthetic has already been written by other authors.

This manuscript arises from the attention paid to the fascial block of increasing interest in anesthesiological practice. We understood, drawing on the clinic and also on the bibliography on the subject, that the dynamic execution of the block allows a better performance.

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