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Pecto-intercostal Fascial Block for Acute Poststernotomy Pain: A Case Report

Liu, Victor, MD*; Mariano, Edward, R., MD, MAS†,‡; Prabhakar, Christopher, MD, FRCPC*,§

doi: 10.1213/XAA.0000000000000697
Case Reports

Sternotomy pain is a common complication after cardiac surgery. We present a 77-year-old patient with severe acute sternal pain after coronary artery bypass graft surgery who was successfully treated with a novel peripheral regional anesthetic technique, the pecto-intercostal fascial block. This interfascial plane block may represent an effective regional anesthetic component of a multimodal analgesic strategy for cardiac surgery patients who suffer from significant pain after a median sternotomy and are typically anticoagulated.

From the *Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, British Columbia, Canada

Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine; Stanford, California

Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California

§Department of Anesthesiology, St. Paul’s Hospital, Providence Health Care, Vancouver, British Columbia, Canada.

Accepted for publication November 16, 2017.

Funding: None.

Conflicts of Interest: See Disclosures at the end of the article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website.

Address correspondence to Christopher Prabhakar, MD, FRCPC, Department of Anesthesiology, St. Paul’s Hospital, 1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada. Address e-mail to

© 2018 International Anesthesia Research Society
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