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Analgesia Management for Mitral Valve Repair Via Minithoracotomy - A Case Report
Andreia Fernandes1, Clara Gaio Lima1, Nelson Paulo1
1Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal.
Summary
Minimally invasive cardiac surgery (MICS) can lead to chronic pain. Local anesthetic infiltration via catheter provided effective pain relief for a MICS patient, allowing early extubation and discharge with no pain reported weeks later.
Area of Science:
- Cardiology
- Anesthesiology
- Pain Management
Background:
- Minimally invasive cardiac surgery (MICS) aims for faster recovery but carries a risk of chronic post-thoracotomy pain.
- Intercostal nerve injury is a common cause of chronic pain after thoracic surgery.
- Regional anesthesia techniques are crucial for optimizing post-surgical outcomes.
Observation:
- A 63-year-old female with multiple comorbidities underwent minimally invasive mitral valve repair and cryoablation.
- The procedure involved general anesthesia, cardiopulmonary bypass, and a minithoracotomy.
- A local anesthetic (ropivacaine) catheter was placed near the intercostal space before skin closure.
Findings:
- The patient was extubated 3 hours post-surgery and discharged on postoperative day 4 with no complications.
- No additional local anesthetic boluses were required during the 2-day ICU stay.
- Three weeks post-surgery, the patient reported no pain and high satisfaction with analgesia.
Implications:
- Local anesthetic infiltration via catheter offers effective, prolonged analgesia for MICS.
- This technique can reduce the need for systemic opioids, mitigate the stress response, and prevent pain chronification.
- Optimized regional analgesia contributes to improved patient recovery and satisfaction after thoracic surgery.
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