Bilateral Subpectoral Interfascial Plane Catheters for Analgesia for Sternal Fractures

Abstract

The patient was successfully treated with a continuous infusion of local anesthetic into the subpectoral interfascial plane. We also discuss the use and potential benefits of the subpectoral interfascial plane block in the treatment of pain from sternal fractures.

Periosteal Infusion of Local Anesthetics as an Alternative to Bilateral Subpectoral Interfascial Plane Catheters in Patients With Sternal Fractures

“…As the authors state, blockade of the anterior branches of the intercostal nerves would be required for sternal analgesia, and this would be very unlikely with a serratus plane block. 2 We would also like to highlight the existence of a single-catheter technique first described by Duncan et al 3 to infuse local anaesthetic directly over the fracture site. Our findings have been similar to the results of a case series evaluating the technique, 4 as we have found that this technique results in excellent analgesia for sternal fractures.…”

“…2 We are grateful to them for pointing out that the abbreviation SIP was, at one point, used to refer to the serratus interfascial plane block as well as the subpectoral interfascial plane block. We use the abbreviation SIP to indicate subpectoral interfascial plane block.…”

“…Rather, it was the potential to provide adequate analgesia with few adverse effects and complications, a critical factor being the opportunity to avoid injecting local anesthetic injection into the "anatomical tiger-country" of the neck. 2 In addition, as terminal nerves have a higher ratio of connective tissue, blocking them should theoretically be safer than injecting at the level of the cervical nerve roots, where a lower connective tissue ratio exists and where the nerves seem susceptible to short-and long-term neurological issues following interscalene block (ISB). 3,4 A major benefit of CSANB is the ability to avoid upper-limb paralysis following shoulder surgery.…”

Similarities between parasternal intercostal nerve block and subpectoral interfascial plane block

“…), Raza et al [2] described subpectoral interfascial plane block (SIP block) as a useful technique for pain caused by sternal fractures. In this technique, using the needle approach, local anesthetic is injected into the SIP between the PM and EIM aponeurosis at 2 cm lateral to the sternal edge.…”

An Anatomical Basis for Naming Plane Blocks of the Anteromedial Chest Wall

“…[1][2][3][4] It seems to be an unfortunate but perhaps inevitable fact that the development of new plane block techniques is accompanied by a profusion of different names that are applied to what are otherwise very similar approaches. This difference in nomenclature/terminology is largely a result of the different sonographic landmarks that each group of investigators chooses to focus on in describing and performing their technique.…”