Relocation of an Infected Cardiac Pacemaker Generator Under Ultrasound-Guided Pectoralis Nerve Block: A Case Study

Şahin, Ayhan; Baran, Onur

doi:10.1213/xaa.0000000000000911

Cited by 3 publications

(8 citation statements)

References 13 publications

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“…There were 42 non‐randomised studies: 13 comparative cohort studies ; 19 case series ; and 10 case reports . Six of the cohort studies ; 14 of the case series ; and seven of the case reports were available only as abstracts or posters from conference proceedings.…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen non‐randomised studies evaluated PECS blocks in a wide range of cardiothoracic applications, including: thoracotomy; sternotomy; transcatheter cardiac procedures; cardiac device placement; and thoracic trauma. These comprised: four comparative cohort studies ; seven case series ; and two case reports .…”

Section: Resultsmentioning

confidence: 99%

“…There were 42 non-randomised studies: 13 comparative cohort studies [22][23][24][25][26][27][28][29][30][31][32][33][34]; 19 case series [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53]; and 10 case reports [54][55][56][57][58][59][60][61][62][63]. Six of the cohort studies [25][26][27][28][29]33]; 14 of the case series [35, 36, 38-43, 46-49, 52, 53]; and seven of the case reports [55,[57]…”

Section: Resultsmentioning

confidence: 99%

“…Six of the cohort studies [25][26][27][28][29]33]; 14 of the case series [35, 36, 38-43, 46-49, 52, 53]; and seven of the case reports [55,[57][58][59][60][61][62] were available only as abstracts or posters from conference proceedings. Twenty-nine non- [24,27,28,33]; seven case series [35,39,43,44,46,49,52]; and two case reports [56,61].…”

Section: Resultsmentioning

confidence: 99%

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The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review

et al. 2020

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Summary Serratus anterior plane and pectoral nerves blocks are recently described alternatives to established regional anaesthesia techniques in cardiac surgery, thoracic surgery and trauma. We performed a systematic review to establish the current state of evidence for the analgesic role of these fascial plane blocks in these clinical settings. We identified relevant studies by searching multiple databases and trial registries from inception to June 2019. Study heterogeneity prevented meta‐analysis and studies were instead qualitatively summarised and stratified by type of surgery and comparator. We identified 51 studies: nine randomised control trials; 13 cohort studies; 19 case series; and 10 case reports. The majority of randomised controlled trials studied the serratus anterior plane block in thoracotomy or video‐assisted thoracoscopic surgery, with only two investigating pectoral nerves blocks. The evidence in thoracic trauma comprised only case series and reports. Results indicate that single‐injection serratus anterior plane and the pectoral nerves blocks reduce pain scores and opioid consumption compared with systemic analgesia alone in cardiothoracic surgery, cardiac‐related interventional procedures and chest trauma for approximately 6–12 h. The duration of action appears longer than intercostal nerve blocks but may be shorter than thoracic paravertebral blockade. Block duration may be prolonged by a continuous catheter technique with potentially similar results to thoracic epidural analgesia. There were no reported complications and the risk of haemodynamic instability appears to be low. The current evidence, though limited, supports the efficacy and safety of serratus anterior plane and the pectoral nerves blocks as analgesic options in cardiothoracic surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review

et al. 2020

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“…Traditionally, PECS block has been used exclusively for breast surgery to provide post-operative pain management or as part of multimodal analgesia to reduce opioid consumption. Relevant case reports include PECS block in combination with an intercostal nerve block with IV dexmedetomidine for the sub-pectoral implantation of a cardiac resynchronization therapy device (5), PECS block for implantable cardioverter defibrillator insertion in young patients with Duchenne muscular dystrophy with intercostal block and IV sedation (6), PECS for ICD in a super obese patient (7), and relocation of an infected cardiac pacemaker generator under PECS II block using IV midazolam (8).…”

Section: Discussionmentioning

confidence: 99%

Pectoralis Plane Block for Pacemaker Insertion: A Successful Primary Anesthetic

2019

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Effective anesthesia, analgesia, and hemodynamic stability is important to maintain during pacemaker implantation surgery, especially in the elderly population and patients with compromised cardiac function. As a strategy to avoid the need for intravenous (IV) anesthetics, peripheral nerve block techniques may be used in these specific cases. We report a case of successful pacemaker implantation surgery in a patient with severe Aortic Stenosis (AS) and Sick Sinus Syndrome (SSS) using unilateral pectoralis plane block for surgical anesthesia. Since general anesthesia was considered risky, monitored anesthesia care utilizing peripheral nerve block was planned. A single shot left side pectoralis plane block (PECS II) was done under ultrasound guidance injecting a total of 20 mL of 0.5% Ropivacaine with 1% Lidocaine. No sedation was needed. The patient tolerated the procedure with no significant hemodynamic changes. Patient did not require opioids post-operative and was discharged home in stable condition the next day. This case highlights that PECS block can also provide effective surgical anesthesia for relatively long procedures avoiding the risk of complications associated with IV anesthesia in high risk cardiovascular patients. Additionally, these blocks can provide an opioid sparing option for post-operative management in pacemaker implantation surgeries.

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Pectoral nerve blocks for transvenous subpectoral pacemaker insertion in children: a randomized controlled study

Elhaddad

Hefnawy

Elaziz

et al. 2023

Korean J Anesthesiol

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Background: Postoperative pain management after pacemaker insertion routinely uses either opioid agents, nonsteroid anti-inflammatory drugs, or paracetamol. There has been increased interest in opioidsparing multimodal pain management to minimize postoperative narcotic use. This study aims to assess postoperative pain control and opioid consumption provided by pectoral nerve blocks (PECs) versus standard postoperative pain control in pediatric patients after transvenous subpectoral pacemaker insertion.Method: in this randomized controlled study, forty pediatric patients presented for transvenous subpectoral pacemaker insertion, with either congenital or post-operative complete heart block(CHB). :Patients were randomly assigned into two groups according to the method of perioperative pain management, Group C (control) received conventional analgesic care without any block and Group P (pectoral) received PECs. Demographics, procedural variables, postoperative pain, and postoperative opioid usage were compared between the two groups.Results:: Intra-procedure, pectoral nerve blocks reduced cumulative dose of fentanyl and atracurium with better hemodynamic profile and longer procedure time. Post-procedure, pectoral nerve blocks reduced postprocedural pain scores, which was reflected in later first call for rescue analgesia, and lower postoperative morphine consumption, and did not increase rates of complications in children who underwent transvenous subpectoral pacemaker insertion. Conclusion:Ultrasound guided PECs have a good intraoperative hemodynamic profile, reduce postoperative pain scores, and lower total opioid usage in children who underwent transvenous subpectoral pacemaker placement.

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Relocation of an Infected Cardiac Pacemaker Generator Under Ultrasound-Guided Pectoralis Nerve Block: A Case Study

Cited by 3 publications

References 13 publications

The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review

The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review

Pectoralis Plane Block for Pacemaker Insertion: A Successful Primary Anesthetic

Pectoral nerve blocks for transvenous subpectoral pacemaker insertion in children: a randomized controlled study

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