PADUCAH — Mercy Health Physician Daniel Howard, MD is the only breast surgeon in the region and the first in Western Kentucky to use the latest anesthetic procedure on patients having breast surgery. Known as a pectoralis block or pecs block, this nerve block provides pain relief throughout the surgery and for days afterwards.  

 While nerve blocks have been available for some time to surgery patients, improvements in ultrasound guidance have seen surgeons using this anesthetic tool with increasing frequency.

 “Nerve blocks enable us to operate on areas without pain to the patient and patients having nerve blocks require fewer heavy drugs for their anesthesia,” says Dr. Howard. “We can give them something more akin to twilight sleep, so they wake up refreshed instead of feeling hungover for a week.”

 Over the course of three years, Dr. Howard has administered the pecs block to about 1,000 patients having lumpectomies, mastectomies, reconstructions or any benign or cosmetic breast surgery. After the patient goes into the operating room, he uses real-time ultrasound guidance to inject the patient with numbing medication precisely around the nerve near the surgical site. It takes less than five minutes to complete the injection. The nerve absorbs the medication and when it’s numb, it can’t send pain signals to the brain. Without those signals, patients don’t feel pain.

 “The block works through surgery and provides pain relief for as long as three days after surgery,” says Dr. Howard. “Because patients don’t hurt during surgery, we can use less anesthetic during their procedure. We can also send them home with a minimum of pain pills, in line with the new federal guidelines, since the nerve block controls their pain for days after surgery. It’s hugely advantageous to the patient.”


Patient Bobbie Edds of Paducah agrees.

 “It was the most wonderful experience I’ve had as far as surgery,” she says of her mastectomy. “The block lasted for three days and I could lift my arms up. There was no pain whatsoever. It was a miracle! I didn’t feel like I had surgery. I came home and had energy. I’ve worked out and been more sore.”

 The nerve block can make surgery an option for more older and more fragile patients.

 “You can give this block to people who are older or who have health problems, such as a bad heart, and put almost no stress on their heart and lungs during surgery,” says Dr. Howard. 

To qualify for a pecs block, a patient must be able to lay flat and breathe normally in that position.