Continuous Pectoral Fascia Blocks for Postoperative Analgesia After Median Sternotomy: A Case Report.

We report a novel case of a patient who presented for aortic valve replacement via median sternotomy. Bilateral continuous pectoral fascia blocks were placed to provide postoperative analgesia. Both numerical rating scale pain scores and opioid consumption after surgery were suggestive of analgesic benefit.

[1]  Stephanie E. Moser,et al.  New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults , 2017, JAMA surgery.

[2]  J. Branney,et al.  Liposomal bupivacaine peripheral nerve block for the management of postoperative pain. , 2017, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[3]  R. Barth,et al.  Wide Variation and Excessive Dosage of Opioid Prescriptions for Common General Surgical Procedures , 2017, Annals of surgery.

[4]  G. Woodworth,et al.  Perioperative Breast Analgesia: A Qualitative Review of Anatomy and Regional Techniques , 2017, Regional Anesthesia & Pain Medicine.

[5]  I. Bala,et al.  Efficacy of pectoral nerve block versus thoracic paravertebral block for postoperative analgesia after radical mastectomy: a randomized controlled trial. , 2016, British journal of anaesthesia.

[6]  M. Narayanan,et al.  Bilateral Subpectoral Interfascial Plane Catheters for Analgesia for Sternal Fractures: A Case Report , 2015, Regional Anesthesia & Pain Medicine.

[7]  Joshuel A Pahang,et al.  Reduced Length of Hospitalization in Primary Total Knee Arthroplasty Patients Using an Updated Enhanced Recovery After Orthopedic Surgery (ERAS) Pathway. , 2015, The Journal of arthroplasty.

[8]  G. N. Bashandy,et al.  Pectoral Nerves I and II Blocks in Multimodal Analgesia for Breast Cancer Surgery: A Randomized Clinical Trial , 2014, Regional Anesthesia & Pain Medicine.

[9]  M. Shah,et al.  Cost and Quality Implications of Opioid‐Based Postsurgical Pain Control Using Administrative Claims Data from a Large Health System: Opioid‐Related Adverse Events and Their Impact on Clinical and Economic Outcomes , 2013, Pharmacotherapy.

[10]  G. Nuttall,et al.  A Prospective, Randomized, Blinded Study of Continuous Ropivacaine Infusion in the Median Sternotomy Incision Following Cardiac Surgery , 2012, Regional Anesthesia & Pain Medicine.

[11]  M. Fajardo,et al.  Ultrasound description of Pecs II (modified Pecs I): a novel approach to breast surgery. , 2012, Revista espanola de anestesiologia y reanimacion.

[12]  P. Myles,et al.  A comparison of the analgesic efficacy and side-effects of paravertebral vs epidural blockade for thoracotomy--a systematic review and meta-analysis of randomized trials. , 2006, British journal of anaesthesia.

[13]  L. Lorini,et al.  Ineffectiveness of Local Wound Anesthesia to Reduce Postoperative Pain After Median Sternotomy , 2005, Journal of cardiac surgery.

[14]  John A. Cowan,et al.  Efficacy of postoperative epidural analgesia: a meta-analysis. , 2003, JAMA.

[15]  Anthony Rodgers,et al.  Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials , 2000, BMJ : British Medical Journal.