Table 1.

Summary of Recommendations for Plastic Surgeons

Block	Administration	Indication	Evidence†
Transversus abdominis plane blocks	Local anesthetic between the internal oblique and transversus abdominis muscle	Abdominoplasty	Strong
		Abdominal-based flap reconstruction (ie, TRAM flap)	Strong
		Abdominal wall reconstruction	Limited
Pectoralis blocks	Local anesthetic between the pectoral major and minor muscles	Breast surgery*	Strong
Modified pectoralis blocks	Local anesthetic between the pectoralis major and minor muscles and between the pectoralis minor and serratus anterior muscles	Breast surgery*	Strong
Serratus anterior plane blocks	Local anesthetic between superficial and deep to the serratus anterior muscle	Breast surgery*	Strong
Erector spinae plane blocks†	Local anesthetic between rhomboid major and erector spinae muscles	Breast surgeries*	Strong

*Breast surgeries include mastectomies, breast reconstructions, and reduction mammoplasties; however, majority of the evidence is with regard to mastectomies.

†Evidence strength is based on the number of RCTS and non-level 1 studies—strong: the majority of the RCTs and level-1 evidence supports its use; limited: few level-1 evidence and/or majority of non-level 1 evidence support its use.