Pectointercostal Fascial Block (PIFB) as a Novel Technique for Postoperative Pain Management in Patients Undergoing Cardiac Surgery

Objective: To determine the efficacy of pectointercostal fascial block in relieving postoperative pain in patients undergoing cardiac surgery. Design: Single-blinded, prospective, randomized controlled trial. Setting: Single-center tertiary care teaching hospital. Participants: A total 40 participants undergoing cardiac surgery aged 18 to 80 years. Interventions: Subjects were categorized into 2 groups of 20 each. In group 2 participants (interventional group), bilateral pectointercostal fascial block was given using ropivacaine injection 0.25% after completion of surgery, before shifting to the intensive care unit. Measurements and Main Results: Postoperative pain was measured after extubation at 0, 3, 6, and 12 hours, using a numeric rating scale. Pain in group 2 was significantly less and lasted for a longer duration than in group 1. Fentanyl requirement was significantly higher in group 1 (1.06 ± 0.12 µ/kg) than in group 2 (0.82 ± 0.19 µ/kg). Conclusions: Pectointercostal fascial block is an easy and efficient technique to reduce postoperative pain after cardiac surgery. Objective: To determine the efficacy of pectointercostal fascial block in relieving postoperative pain in patients undergoing cardiac surgery. Design: Single-blinded, prospective, randomized controlled trial. Setting: Single-center tertiary care teaching hospital. Participants: A total 40 participants undergoing cardiac surgery aged 18 to 80 years. Interventions: Subjects were categorized into 2 groups of 20 each. In group 2 participants (interventional group), bilateral pectointercostal fascial block was given using ropivacaine injection 0.25% after completion of surgery, before shifting to the intensive care unit. Measurements and Main Results: Postoperative pain was measured after extubation at 0, 3, 6, and 12 hours, using a numeric rating scale. Pain in group 2 was significantly less and lasted for a longer duration than in group 1. Fentanyl requirement was significantly higher in group 1 (1.06 ± 0.12 µ/kg) than in group 2 (0.82 ± 0.19 µ/kg). Conclusions: Pectointercostal fascial block is an easy and efficient technique to reduce postoperative pain after cardiac surgery. Combined Pectoral-Intercostal Fascial Plane and Rectus Sheath Blocks for Opioid-Sparing Pain Control After Extended Sternotomy for Traumatic Nail Gun InjuryJournal of Cardiothoracic and Vascular AnesthesiaVol. 35Issue 5PreviewWE READ WITH interest the recent articles by Khera et al.1 and Kumar et al.2 that reported pectoral-intercostal fascial plane block is easy to perform and efficient to reduce postoperative pain and opioid consumption after elective cardiac surgery. However, traumatic cardiothoracic injury can make surgical procedures and postoperative analgesic requirements unpredictable. Recently, we encountered a nail gun injury that required a pericardial window followed by a full sternotomy. Sternotomy and upper abdominal wall surgery are painful surgical procedures that can impede pulmonary function and overall recovery goals. Full-Text PDF