Effects of continuous pecto-intercostal fascial block for management of post-sternotomy pain in patients undergoing cardiac surgery: a randomized controlled trial

作者：Yanfei Zhao, Dehao He, Wanqing Zhou, Cheng Chen, Zhuoyi Liu, Pingping Xia, Zhi Ye, Chunling Li · 发表于：International Journal of Surgery · 年份：2024 · DOI：10.1097/js9.0000000000002200 · 被引用次数：9 · 研究领域：Anesthesia and Pain Management、Pediatric Pain Management Techniques、Surgical site infection prevention

BACKGROUND: Managing postoperative pain following median sternotomy has long been a notable challenge for anesthesiologists. The administration of postoperative analgesia traditionally relies on intravenous pumps for the delivery of opioids. With the development of regional block techniques and postoperative multimodal analgesia, pecto-intercostal fascial block (PIFB) has gained widespread utilization due to its distinctive advantages. However, its application is limited to a single block. This study aimed to indicate whether continuous PIFB analgesia in cardiac surgery via sternotomy could possess clinical advantages compared with intravenous analgesia in terms of postoperative pain management. If continuous PIFB analgesia was the priority, the secondary objective would involve determining the most effective administration method, making it a critical area of exploration. METHODS: Totally, 114 patients were randomly allocated to three groups: the patient-controlled intravenous analgesia (PCIA) group, receiving intravenous opioid infusion exclusively via pump, and the constant infusion pecto-intercostal fascial block (C-PIFB) and intermittent infusion pecto-intercostal fascial block (I-PIFB) groups, where ultrasound-guided PIFB with a nerve-blocking pump was administered. The C-PIFB group received a constant basal infusion, while programmed intermittent boluses were administered in the I-PIFB group. The primary end point was postoperative visual analog scale (VAS) scores, and...