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Background and Aims Presently, minimally invasive procedures like minimal access surgery is preferred for elective By-Pass surgery as it provides the cosmetic advantage and avoids sternal complications like infection and postoperative pain. Even with this surgical technique, postoperative pain is often intense and challenging to control. Recently, we have described a novel interfascial plane block technique: Serratus posterior superior intercostal plane block (SPSIB). SPSIB is performed into the fascial plane between serratus posterior superior muscle and the intercostal muscles at the level of second and third rib. Herein, we want to report our successful analgesic experiences of SPSIB in 3 patients underwent minimal access By-Pass surgery.
Methods Written informed consents were obtained from the patients for this report. After the identification of the anatomical landmarks with US guidance the transducer was slightly rotated to obtain an oblique visualization. The needle was inserted just above the third rib deeply to the SPSm. 30 ml of 0.25% bupivacaine administrated between SPSm and rib. We evaluated the pain levels with the Numeric Rating Scale (NRS) for the postoperative 24 hours period.
Conclusions The advantages of SPSIB are; it is safe and simple due to US-guidance. Since the second or third rib is an anatomical landmark, it is a naturel barrier in front of the pleura. Considering that SPSIB is a superficial block, it can be performed more safely in patients receiving anticoagulation therapy. In conclusion, SPSIB may be a good choice for postoperative analgesia management as a part of multimodal analgesia in patients minimally invasive cardiac surgery.
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