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胸肋-肋间筋膜平面阻滞用于心胸外科手术后的疼痛管理

Pecto-Intercostal Fascial Plane Block for Pain Management after Cardiothoracic Surgery.

作者信息

Kaye Alan D, Vuong Christopher A, Hawkins Alison M, Serio Macie A, Dethloff Drew R, Hollander Alex V, Ahmadzadeh Shahab, Skidmore Kimberly L, Palowsky Zachary R, Shekoohi Sahar

机构信息

Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA.

School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.

出版信息

Curr Pain Headache Rep. 2025 May 15;29(1):84. doi: 10.1007/s11916-025-01398-9.

DOI:10.1007/s11916-025-01398-9
PMID:40375035
Abstract

PURPOSE OF REVIEW

Cardiac surgery is associated with significant postoperative pain. Compared to traditional analgesics, regional nerve blocks target specific anatomical areas to improve analgesia and to reduce postoperative opioid consumption.

RECENT FINDINGS

Pecto-intercostal fascial plane block (PIFB) is a novel analgesic technique that involves ultrasound-guided injection of anesthetic between pectoralis major and external intercostal muscles. Since PIFB is a relatively underexplored method of analgesia, to date, few manuscripts have reviewed and synthesized current literature related to PIFB.

CONCLUSION

The present investigation focuses on relevant anatomy and physiology behind the PIFB, compares this novel technique with other traditional and novel methods of analgesia, and describes indications and contraindications for PIFB in cardiac surgery and other surgeries.

摘要

综述目的

心脏手术与显著的术后疼痛相关。与传统镇痛药相比,区域神经阻滞针对特定解剖区域以改善镇痛效果并减少术后阿片类药物的使用。

最新发现

胸肋筋膜平面阻滞(PIFB)是一种新型镇痛技术,涉及在超声引导下将麻醉剂注射到胸大肌和肋间外肌之间。由于PIFB是一种相对未被充分探索的镇痛方法,迄今为止,很少有手稿对与PIFB相关的当前文献进行综述和综合。

结论

本研究聚焦于PIFB背后的相关解剖学和生理学,将这种新技术与其他传统和新型镇痛方法进行比较,并描述了PIFB在心脏手术和其他手术中的适应证和禁忌证。

相似文献

1
Pecto-Intercostal Fascial Plane Block for Pain Management after Cardiothoracic Surgery.胸肋-肋间筋膜平面阻滞用于心胸外科手术后的疼痛管理
Curr Pain Headache Rep. 2025 May 15;29(1):84. doi: 10.1007/s11916-025-01398-9.
2
Effects of continuous pecto-intercostal fascial block for management of post-sternotomy pain in patients undergoing cardiac surgery: a randomized controlled trial.持续胸肌-肋间筋膜阻滞对心脏手术患者胸骨切开术后疼痛管理的效果:一项随机对照试验。
Int J Surg. 2025 Feb 1;111(2):2037-2045. doi: 10.1097/JS9.0000000000002200.
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The Analgesic Efficacy of Pecto-Intercostal Fascial Block Combined with Pectoral Nerve Block in Modified Radical Mastectomy: A Prospective Randomized Trial.改良根治性乳腺癌手术中胸肌间沟筋膜平面阻滞联合肋间臂神经阻滞的镇痛效果:一项前瞻性随机试验。
Pain Physician. 2020 Sep;23(5):485-493.
4
Comparison of Transversus Thoracis Muscle Plane Block and Pecto-Intercostal Fascial Plane Block for enhanced recovery after pediatric open-heart surgery.比较经胸横肌平面阻滞和胸肌肋间筋膜平面阻滞对小儿心脏直视手术后加速康复的效果。
Anaesth Crit Care Pain Med. 2023 Aug;42(4):101230. doi: 10.1016/j.accpm.2023.101230. Epub 2023 Apr 7.
5
Comparison of the effects of transversus thoracic muscle plane block and pecto-intercostal fascial block on postoperative opioid consumption in patients undergoing open cardiac surgery: a prospective randomized study.经胸横肌平面阻滞与胸肌肋间筋膜阻滞对行开胸心脏手术患者术后阿片类药物消耗影响的比较:一项前瞻性随机研究。
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Opioid free postoperatively using Pecto-Intercostal Fascial Block (PIFB) with multimodal Analgesia (MMA) in a patient with myasthenia gravis underwent thymectomy via sternotomy.在一名重症肌无力患者经胸骨切开术行胸腺切除术后,使用胸肋筋膜阻滞(PIFB)联合多模式镇痛(MMA)实现术后无阿片类药物使用。
J Clin Anesth. 2020 Feb;59:32-33. doi: 10.1016/j.jclinane.2019.06.009. Epub 2019 Jun 11.
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Ultrasound-Guided Pecto-Intercostal Fascial Block for Postoperative Pain Management in Cardiac Surgery: A Prospective, Randomized, Placebo-Controlled Trial.超声引导下胸肋筋膜阻滞用于心脏手术术后疼痛管理的前瞻性随机安慰剂对照试验。
J Cardiothorac Vasc Anesth. 2021 Mar;35(3):896-903. doi: 10.1053/j.jvca.2020.07.058. Epub 2020 Jul 24.
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Comparison of Ultrasound-Guided Pecto-intercostal Fascial Block and Transversus Thoracic Muscle Plane Block for Acute Poststernotomy Pain Management After Cardiac Surgery: A Prospective, Randomized, Double-Blind Pilot Study.超声引导下胸肌间沟筋膜阻滞与经胸横肌平面阻滞在心脏手术后急性胸骨后疼痛管理中的比较:一项前瞻性、随机、双盲的初步研究。
J Cardiothorac Vasc Anesth. 2022 Aug;36(8 Pt A):2313-2321. doi: 10.1053/j.jvca.2021.09.041. Epub 2021 Oct 1.
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Effects of pecto-intercostal fascial block combined with rectus sheath block for postoperative pain management after cardiac surgery: a randomized controlled trial.心脏手术后应用肋间筋膜与腹直肌鞘阻滞联合镇痛对术后疼痛管理的影响:一项随机对照试验。
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本文引用的文献

1
Thoracolumbar interfascial plane block and erector spinae plane block for postoperative analgesia in patients undergoing spine surgery.胸腰段筋膜平面阻滞和竖脊肌平面阻滞用于脊柱手术患者的术后镇痛。
Anaesthesiol Intensive Ther. 2021;53(4):366-367. doi: 10.5114/ait.2021.108157.
2
Bilateral Subpectoral Interfascial Plane Catheters for Analgesia for Sternal Fractures: A Case Report.双侧胸大肌筋膜间平面导管用于胸骨骨折镇痛:一例报告
Reg Anesth Pain Med. 2016 Sep-Oct;41(5):607-9. doi: 10.1097/AAP.0000000000000388.
3
Non-steroidal anti-inflammatory drug administration after coronary artery bypass surgery: utilization persists despite the boxed warning.
冠状动脉搭桥手术后使用非甾体抗炎药:尽管有黑框警告,使用率仍居高不下。
Pharmacoepidemiol Drug Saf. 2015 Jun;24(6):647-53. doi: 10.1002/pds.3788. Epub 2015 Apr 22.