Clinical Benefits of Parasternal Block with Multihole Catheters when Inserted before Sternotomy

Area of Science:

• Anesthesiology
• Cardiothoracic Surgery
• Pain Management

Background:

• Sternotomy for cardiac surgery often results in significant postoperative pain.
• Effective pain management is crucial for patient recovery and reducing opioid-related complications.

Purpose of the Study:

• To evaluate the efficacy of parasternal block with multihole catheters for postoperative analgesia.
• To assess the potential for opioid reduction in cardiac surgery patients.

Main Methods:

• A prospective, single-group trial involving 26 adult patients undergoing sternotomy.
• Placement of bilateral parasternal multihole catheters before incision for continuous ropivacaine infusion.
• Assessment of pain scores (rest, dynamic) and 48-hour morphine consumption.

Main Results:

• The parasternal block was considered effective in 15 of 26 patients.
• 88% of patients reported a mean pain score ≤3.5/10 during coughing.
• Morphine consumption was significantly lower (7 mg) compared to controls (142 mg) (P < 0.001).

Conclusions:

• Parasternal block with pre-incisional multihole catheter insertion is an effective analgesic technique.
• This method significantly reduces postoperative opioid requirements in cardiac surgery.
• The technique offers a promising approach to enhance pain management after sternotomy.