Abstract
Introduction This prospective, hospital-based, cross-sectional, case-control study reports on the effectiveness of a novel loco-regional approach to provide analgesia in cardiac surgery, the ultrasound (US)-guided pectoralis-intercostal rectus-sheath (PIRS) block(1), a modified combination of pectoralis and rectus-sheath blocks, respectively. It is intended to provide analgesia for sternotomy and surgical sites of chest drains, by effectively covering the T1-T10 dermatomes. Methods In this prospective hospital-based cross-sectional case-control study, 31 patients received interfascial US-guided PIRS with levobupivacaine 0.25% immediately after induction of general anaesthesia and, again, immediately after surgery. Patients undergoing coronary artery bypass grafting also received saphenous nerve blockade to cover the vein harvesting sites. Postoperative opioid analgesia, extubation time, length of intensive care and hospital stay were recorded. Outcomes for the PIRS group were compared with a historical control group of 30 patients matched for gender, age,risk profile and timing of surgery, who received conventional opioid analgesia. Results The extubation time was 2.5 hours in the PIRS group (1-3.5), reduced from 7.5 in the control group (6-14) (interquartile range, p-value Discussion The US-guided PIRS block could be a useful technique for the provision of effective intra-, and post-, operative analgesia at the sites of cardiac surgery.
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