Title | Efficacy of parasternal peripheral nerve catheters versus no block for median sternotomy: a single-centre retrospective study. |
Publication Type | Journal Article |
Year of Publication | 2024 |
Authors | Rubin JE, Ng V, Chung J, Salvatierra N, Rippon B, Khatib D, Girardi NI, Pryor KO, Weinberg RY, Jiang S, Khairallah S, Mick SL, Tedore TR |
Journal | BJA Open |
Volume | 11 |
Pagination | 100288 |
Date Published | 2024 Sep |
ISSN | 2772-6096 |
Abstract | BACKGROUND: Sternal pain after cardiac surgery results in considerable discomfort. Single-injection parasternal fascial plane blocks have been shown to reduce pain scores and opioid consumption during the first 24 h after surgery, but the efficacy of continuous infusion has not been evaluated. This retrospective cohort study examined the effect of a continuous infusion of local anaesthetic through parasternal catheters on the integrated Pain Intensity and Opioid Consumption (PIOC) score up to 72 h. METHODS: We performed a retrospective analysis of patients undergoing cardiac surgery with median sternotomy at a single academic centre before and after the addition of parasternal nerve catheters to a standard multimodal analgesic protocol. Outcomes included PIOC score, total opioid consumption in oral morphine equivalents, and time-weighted area under the curve pain scores up to 72 h after surgery. RESULTS: Continuous infusion of ropivacaine 0.1% through parasternal catheters resulted in a significant reduction in PIOC scores at 24 h (-62, 95% confidence interval -108 to -16; P<0.01) and 48 h (-50, 95% CI -97 to -2.2; P=0.04) compared with no block. A significant reduction in opioid consumption up to 72 h was the primary factor in reduction of PIOC. CONCLUSIONS: This study suggests that continuous infusion of local anaesthetic through parasternal catheters may be a useful addition to a multimodal analgesic protocol in patients undergoing cardiac surgery with sternotomy. Further prospective study is warranted to determine the full benefits of continuous infusion compared with single injection or no block. |
DOI | 10.1016/j.bjao.2024.100288 |
Alternate Journal | BJA Open |
PubMed ID | 39007154 |
PubMed Central ID | PMC11245929 |