Safety of Ultrasound-Guided Serratus Anterior and Erector Spinae Fascial Plane Blocks: A Retrospective Analysis in Patients Undergoing Cardiac Surgery While Receiving Anticoagulant and Antiplatelet Drugs

Toscano, Antonio; Capuano, Paolo; Galatà, Michela; Tazzi, Ilaria; Rinaldi, Mauro; Brazzi, Luca

doi:10.1053/j.jvca.2021.05.037

Cited by 27 publications

(22 citation statements)

References 23 publications

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“…Data for minimally invasive cardiac surgery are limited to observational studies, but initial research suggests ESPB may be effective and safe, [68][69][70] even in the setting of mild anticoagulation. 71 A randomized trial evaluating the ability of ESPB to reduce opioid consumption after minimally invasive mitral valve surgery is ongoing. 72 Serratus anterior plane block.…”

Section: Peripheral Nerve Blocksmentioning

confidence: 99%

“…19 In minimally invasive cardiac surgery, SAPB appears to be safe and effective even in the setting of anticoagulation. 71,81,82 However, once again, compared with alternatives, it may be inferior. Moll et al 83 found that compared with PVB, patients treated with a SAPB had increased pain scores and opioid consumption, suggesting the analgesic coverage of the posterior thorax may be inadequate.…”

Section: Peripheral Nerve Blocksmentioning

confidence: 99%

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Pain Management Strategies for Minimally Invasive Cardiothoracic Surgery

Sherazee

Chen

et al. 2022

Innovations�(Phila)

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Section: Peripheral Nerve Blocksmentioning

confidence: 99%

Section: Peripheral Nerve Blocksmentioning

confidence: 99%

Pain Management Strategies for Minimally Invasive Cardiothoracic Surgery

Sherazee

Chen

et al. 2022

Innovations�(Phila)

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“…Although there is evidence to support a multimodal and safe approach based on regional nerve blocks (3,4) , confirmations of the efficacy of PIRS block are still lacking. Cibelli et al (5) first described the effectiveness of PIRS block in intubated patient undergoing coronary artery bypass grafting, providing analgesia for sternotomy and surgical sites of chest drains, by effectively covering the T1-T10 dermatomes.…”

Section: Discussionmentioning

confidence: 99%

Awake cardiac surgery using the novel Pectoralis-Intercostal-Rectus Sheath (PIRS) Plane Block and Subxiphoid approach

Toscano

Balzani

Capuano

et al. 2022

Preprint

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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-years-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 hours 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.

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“…After the position of the needle tip was confirmed, 10 ml of Ropivacaine 0.75% was administered; the same procedure was performed on the other side (Figure 1B). Although there is evidence to support a multimodal and safe approach based on regional nerve blocks, 3,4 confirmations of the efficacy of PIRS block are still lacking. Cibelli et al 5 first described the effectiveness of PIRS block in intubated patient undergoing coronary artery bypass grafting, providing analgesia for sternotomy and surgical sites of chest drains, by effectively covering the T1-T10 dermatomes.…”

Section: Pirs-techniquementioning

confidence: 99%

Awake cardiac surgery using the novel pectoralis‐intercostal‐rectus sheath (PIRS) plane block and subxiphoid approach

Toscano

Balzani

Capuano

et al. 2022

Journal of Cardiac Surgery

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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.

show abstract

Safety of Ultrasound-Guided Serratus Anterior and Erector Spinae Fascial Plane Blocks: A Retrospective Analysis in Patients Undergoing Cardiac Surgery While Receiving Anticoagulant and Antiplatelet Drugs

Cited by 27 publications

References 23 publications

Pain Management Strategies for Minimally Invasive Cardiothoracic Surgery

Pain Management Strategies for Minimally Invasive Cardiothoracic Surgery

Awake cardiac surgery using the novel Pectoralis-Intercostal-Rectus Sheath (PIRS) Plane Block and Subxiphoid approach

Awake cardiac surgery using the novel pectoralis‐intercostal‐rectus sheath (PIRS) plane block and subxiphoid approach

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