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

Kumar, Ashok; Chauhan, Sandeep; Bhoi, Debesh; Kaushal, Brajesh

doi:10.1053/j.jvca.2020.07.074

Cited by 48 publications

(34 citation statements)

References 23 publications

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“…Despite these data, the reports about the relationship between poststernotomy pain and respiratory function are still lacking. In their studies, Kumar et al 25 study assessed the role of PIFB in improving the quality of oxygenation.…”

Section: Discussionmentioning

confidence: 99%

The Analgesic Effect of Ultrasound-guided Bilateral Pectointercostal Fascial Plane Block on Sternal Wound Pain After Open Heart Surgeries

Hamed

Abdelhady

Hassan

et al. 2022

The Clinical Journal of Pain

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Objectives: We aimed to evaluate the analgesic efficacy of ultrasound-guided bilateral pectointercostal fascial plane block after open heart surgeries.Methods: Seventy patients aged above 18 years and scheduled for on-pump coronary artery bypass grafting or valve replacement or both through median sternotomy were enrolled in this study. Patients were randomly allocated into 2 groups of 35 (block group or control group). The block group had the block performed through 20 ml of a solution of 0.25% bupivacaine plus epinephrine (5 mcg/mL), and the control group received dry needling. The primary outcome was the 24-hour cumulative morphine consumption. The secondary outcomes were time to the first analgesic request, pain score, quality of oxygenation, intensive care unit stays, and hospital stay. Results:The cumulative morphine consumption in the first 24 hours was significantly lower in the block group, with a mean difference of −3.54 (95% confidence interval = −6.55 to −0.53; P = 0.015). In addition, the median estimate time to the first analgesic request was significantly longer in the block group than in the control group. Finally, during the postoperative period (4 to 24 h), mean sternal wound objective pain scores were, on average, 0.58 units higher in the block group.Conclusion: pectointercostal fascial block is an effective technique in reducing morphine consumption and controlling poststernotomy pain after cardiac surgeries. Also, it may have a role in better postoperative respiratory outcomes.

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Section: Discussionmentioning

confidence: 99%

The Analgesic Effect of Ultrasound-guided Bilateral Pectointercostal Fascial Plane Block on Sternal Wound Pain After Open Heart Surgeries

Hamed

Abdelhady

Hassan

et al. 2022

The Clinical Journal of Pain

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“…Moreover, Kumar et al . were able to demonstrate in a randomized controlled trial that in cardiac patients, PIFB provides equal pain relief as an erector spinae plane block with normal tidal volume breathing [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Pectointercostal fascial plane block for rescue pain management of traumatic sternal fracture following inadequate thoracic epidural block: a case report

Hsu

Kinthala

Huang

et al. 2022

Journal of Surgical Case Reports

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Adequate pain control after multisystem trauma including the chest wall is essential for improved patient outcomes, especially with sternum and rib fractures. The thoracic epidural is considered the gold standard in pain management of thoracic injury; however, failure or patchy epidural is not uncommon. Pectointercostal fascial plane block (PIFB) is regularly used in cardiac surgery to provide analgesia to the anterior chest wall; however, there are few reports of PIFB being used as a primary block for the management of thoracic injuries. We present a case in which PIFB was used as a rescue block for the successful management of sternal pain following patchy thoracic epidural block in a patient with thoracic polytrauma.

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“…15 TTPB is not without its risks, such as vascular and pericardial puncture, pneumothorax, local anesthetic systemic toxicity, infection, and nerve damage. PIFB, in which local anesthetic is injected into the fascial plane between the pectoralis major and intercostal muscles, appears to be a safer alternative 16 since, being more superficial, it appears to be associated with fewer risks than TTPB. This, also because the transverse thoracic muscle is difficult to visualize because it is located near the pleura with a consequent greater risk of pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

Transversus thoracic plane block and rectus sheath block for left ventricular assist device implantation via full median sternotomy: A case report

Toscano

Capuano

Attisani

et al. 2022

Journal of Cardiac Surgery

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Background: Traditionally, pain management after left ventricular assist device (LVAD) implantation via median sternotomy have been based on intravenous opioids but, in the era of enhanced recovery after surgery, a multimodal opioid-sparing analgesia could represent a valid alternative reducing opioids related side effects.Case Report: We described the successfully use of an opioid-sparing regimen for

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

Cited by 48 publications

References 23 publications

The Analgesic Effect of Ultrasound-guided Bilateral Pectointercostal Fascial Plane Block on Sternal Wound Pain After Open Heart Surgeries

The Analgesic Effect of Ultrasound-guided Bilateral Pectointercostal Fascial Plane Block on Sternal Wound Pain After Open Heart Surgeries

Pectointercostal fascial plane block for rescue pain management of traumatic sternal fracture following inadequate thoracic epidural block: a case report

Transversus thoracic plane block and rectus sheath block for left ventricular assist device implantation via full median sternotomy: A case report

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