The effectiveness of parasternal blockade during coronary artery bypass grafting: a clinical case

Abstract

BACKGROUND: Regional anesthesia for aortocoronary bypass surgery have shown promise in achieving reduced perioperative pain, need for systemic opioids, and improved surgical outcomes. However, use of neuroaxial anesthesia in cardiac surgery remains controversial due to the lack of studies. Parasternal blockade is a simple, effective technique that can be applied after cardiac surgery.

CLINICAL CASE DESCRIPTION: This is a clinical case presenting the performance of bilateral parasternal blockade in the III–IV intercostal space using the «Single Shot» technique for a patient who underwent aortocoronary bypass surgery. Advantages of this technique are its ease of implementation, safety, and most importantly, effective distribution of local anesthetic in the parasternal interfascial space. This results in blockade of the anterior cutaneous branches of intercostal nerves from T₂ to T₆ that innervate the surgical area.

CONCLUSION: Parasternal blockade is a technically simple, affordable, and promising method for analgesia after aortocoronary bypass surgery. Multicenter studies are required to further evaluate the efficacy of parasternal blockade postcardiac surgery.

Keywords

parasternal block / postoperative pain / multimodal analgesia / ropivacaine / clinical case

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