Antonio Toscano1, Eleonora Balzani2, Paolo Capuano3, Anna Vaninetti2, Chiara Perrucci2, Erika Simonato4, Mauro Rinaldi2,4, Luca Brazzi1,2. 1. Department of Anesthesia, Critical Care and Emergency, 'Città della Salute e della Scienza' Hospital, Torino, Italy. 2. Department of Surgical Sciences, University of Turin, Torino, Italy. 3. Department of Anesthesia and Intensive Care, IRCCS-ISMETT, UPMC, Palermo, Italy. 4. Department of Cardiovascular and Thoracic Surgery, 'Città della Salute e della Scienza' Hospital, Torino, Italy.
Abstract
BACKGROUND: Postoperative pain after cardiac surgery is a very important issue and affects recovery, risk of postoperative complications and quality of life. The pain management has been traditionally based on intravenous opioids with growing evidence suggesting the use of opioid-free and opioid-sparing techniques to reduce its adverse effects. CASE PRESENTATION: We report the case of a 75-year-old frail patient underwent awake mediastinal revision with subxiphoid access due to deep sternal wound infection using a pectoralis-intercostal rectus sheath (PIRS) plane block. During the procedure the patient never reported pain receiving acetaminophen 1 g every 8 h for postoperative pain management without others pain relievers. CONCLUSION: Ultrasound guided PIRS block could be an effective and safe analgesic technique to manage sternal and subxiphoid drainage pain in patients undergoing cardiac surgery via subxiphoid approach.
BACKGROUND: Postoperative pain after cardiac surgery is a very important issue and affects recovery, risk of postoperative complications and quality of life. The pain management has been traditionally based on intravenous opioids with growing evidence suggesting the use of opioid-free and opioid-sparing techniques to reduce its adverse effects. CASE PRESENTATION: We report the case of a 75-year-old frail patient underwent awake mediastinal revision with subxiphoid access due to deep sternal wound infection using a pectoralis-intercostal rectus sheath (PIRS) plane block. During the procedure the patient never reported pain receiving acetaminophen 1 g every 8 h for postoperative pain management without others pain relievers. CONCLUSION: Ultrasound guided PIRS block could be an effective and safe analgesic technique to manage sternal and subxiphoid drainage pain in patients undergoing cardiac surgery via subxiphoid approach.