Superficial parasternal intercostal plane block for sternal fractures in the emergency department

In uncomplicated sternal fractures, one of the first priorities is to treat pain in order to avoid secondary complications due to hospital admission or reduced mobility. We wanted to study the safety and the efficacy of ultrasound-guided superficial parasternal intercostal plane (SPIP) block in pain control in these kinds of patients in the emergency department (ED). SPIP block has proven to be a safe and practical technique in pain control in the operatory room e.g. for heart surgery but its use in the emergency setting is poorly reported. Here we present two cases in which SPIP block was effectively and safely used to treat pain secondary to sternal fractures, allowing a rapid discharge from ED (case 2) or an easier pain control in an admitted patient (case 1). We think that SPIP block should be taken into consideration in case of sternal fractures non responsive to conventional analgesia.