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#34298 Parasternal plane block for the awake sternal surgery
  1. Tam Al-Ani and
  2. Jack Hollinghurst
  1. Anaesthesia, NHS Greater Glasgow and Clyde, Glasgow, UK


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Background and Aims The analgesic efficacy of parasternal plane block in pain management after cardiac surgery and sternal fractures has been reported in multiple studies. However, evidence of its use as a sole anaesthetic technique for awake sternal surgery is scarce. This case report describes using this block technique in awake surgery involving the sternum.

Methods A 66-year-old patient with poorly controlled diabetes and unstable angina due to severe and inoperable multivessel coronary artery disease was booked for debridement and washout of an infected deep sternal wound involving the periosteum. The patient consented to have the procedure awake under a parasternal plane block. An ultrasound-guided bilateral parasternal plane block alongside the lateral edges of the sternal wound was performed using safe doses of local anaesthetic (a total of 40 ml of 3.75mg/ml levobupivacaine) injected in the plane between the medial edge of the pectoralis major muscle anteriorly and the intercostal muscles and ribs posteriorly targeting the anterior cutaneous branches of the intercostal nerves. Written consent was obtained from the patient to publish this abstract.

Results The anaesthesia and surgery were completed uneventfully without any adverse effects on the patient‘s haemodynamics.

Abstract #34298 Figure 1

Parasternal Plane Block- Right side

Abstract #34298 Figure 2

Postoperative VAC dressing

Abstract #34298 Table 1

Block effects

Conclusions Parasternal plane block effectively provided anaesthesia and analgesia for sternum surgery.

  • Parasternal Plane Block

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