Hsu Michael, Kinthala Sudhakar, Huang Jordan, Kapoor Neel, Saththasivam Poovendran, Porter Burdett
Department of Anesthesiology, Guthrie Clinic, Sayre, PA, USA.
J Surg Case Rep. 2022 Mar 30;2022(3):rjac073. doi: 10.1093/jscr/rjac073. eCollection 2022 Mar.
Adequate pain control after multisystem trauma including the chest wall is essential for improved patient outcomes, especially with sternum and rib fractures. The thoracic epidural is considered the gold standard in pain management of thoracic injury; however, failure or patchy epidural is not uncommon. Pectointercostal fascial plane block (PIFB) is regularly used in cardiac surgery to provide analgesia to the anterior chest wall; however, there are few reports of PIFB being used as a primary block for the management of thoracic injuries. We present a case in which PIFB was used as a rescue block for the successful management of sternal pain following patchy thoracic epidural block in a patient with thoracic polytrauma.
对于包括胸壁在内的多系统创伤患者，充分的疼痛控制对于改善患者预后至关重要，尤其是对于胸骨和肋骨骨折患者。胸段硬膜外阻滞被认为是胸部损伤疼痛管理的金标准；然而，硬膜外阻滞失败或效果不佳的情况并不少见。胸肌肋间筋膜平面阻滞（PIFB）常用于心脏手术，为前胸壁提供镇痛；然而，很少有关于将PIFB用作胸部损伤管理的主要阻滞方法的报道。我们报告了一例在一名胸部多发伤患者中，胸段硬膜外阻滞效果不佳后，使用PIFB作为补救性阻滞成功管理胸骨疼痛的病例。
