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Abstract
Application for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)
Background and Aims Median sternotomy (MS) is the most commonly used incision in cardiac surgery. Sternal dehiscence is a rare but alarming complication. Re- administration of general anesthesia may be a problem in these patients. Parasternal intercostal plane (PIP) blocks may not have adequate anesthesia coverage in the lower sternum [figure 1). In this study, our aim was to present the use of a combination of superficial PIP and RIP block as the main anesthesia method in patients undergoing sternum revision surgery and to demonstrate its feasibility.
Methods For this retrospective study, IRB approval was obtained, and included patients undergoing post-MS sternal revision surgery who gave written informed consent to the combination of these blocks as main anesthetic technique.
Results A total of 9 patients who underwent post-MS sternum revision between June 2022 and March 2023 received this combined anesthesia approach. Surgeries were completed without complications, without the need for deep sedation or general anesthesia. Figure 2 shows the surgical incisions, and table 1 presents patient and block characteristics and additional anesthesia requirements.
Dye spread after recto-intercostal plane block in our previous cadaver study
Presentation of perioperative patient incisions
Patients’ descriptives and perioperative outcome measures
Conclusions The PIP block combined with the newly described RIP block and mild sedoanalgesia provides safe and adequate anesthesia for high-risk patients. However, more studies are needed to assess dermatome effects and examine data regarding recovery quality.