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Papers of the Week


2022 Mar


J Surg Case Rep


2022


3

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

Authors

Hsu M, Kinthala S, Huang J, Kapoor N, Saththasivam P, Porter B
J Surg Case Rep. 2022 Mar; 2022(3):rjac073.
PMID: 35368380.

Abstract

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.