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Implementation of Pectointercostal Fascial Plane and Rectus Sheath Block as a Tool in Weaning From Mechanical
Mohammad Zishan Uddin1, Maliha Karim2, Md Abdul Karim3
1Department of Cardiothoracic-Vascular Anesthesia & ICU, Evercare Hospital, Dhaka, Bangladesh.
Abstract:
Successful weaning from mechanical ventilation depends on many factors. Optimizing all factors creates the pathway of liberation from ventilation. Among them, comprehensive pain management is one of the most critical factors, especially for cardiac surgical patients, who require median sternotomy. This case report is about a case of a 55-year-old patient with diabetes mellitus, hypertension, and pneumonia, in whom weaning failed repeatedly after a coronary artery bypass graft operation and was successfully extubated after ultrasound-guided implementation of a combined bilateral pectointercostal fascial plane block and rectus sheath block by reducing pain and improving ventilation, which was evidenced by reduced visual analog scale score and improvement of tidal volume. Integration of regional anesthesia not only provides adequate analgesia but also reduces opioid requirements and facilitates weaning, particularly for postcardiac surgical patients.
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