Clin Exp Emerg Med.  2020 Mar;7(1):67-70. 10.15441/ceem.18.089.

Anterior cutaneous nerve block for analgesia in anterior chest trauma:is the parasternal approach necessary?

Affiliations
  • 1Emergency Medicine Fellowship Program, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
  • 2Servizio Anestesia e Rianimazione 2, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
  • 3IRCCS CROB Centro di Riferimento Oncologico Basilicata, Rionero in Vulture, Potenza, Italy
  • 4Emergency Medicine Fellowship Program, Clinica Medica 2, Department of Internal Medicine, Fondazione IRCCS Policinico San Matteo, University of Pavia, Pavia, Italy

Abstract

In recent years, several techniques of regional anesthesia have been proposed to provide analgesia to the anterior thoracic cage; notably, most of these techniques require a parasternal approach. However, in this context, the potential role of a more common and well-established technique, namely the modified pectoral nerve block (known as PECS II block), has been poorly investigated. Here, we describe a case involving a patient with bilateral anterolateral multiple rib fractures associated with sternum fracture, who was successfully treated using bilateral PECS II blocks. Our experience indicates that the PECS II block can provide excellent analgesia in cases involving anterior rib and sternum fractures. Because it is easier to perform and may be safer than other parasternal techniques, the PECS II block should be considered when providing analgesia for traumatic injuries of the anterior thorax.

Keyword

Rib fractures; Sternum; Nerve block; Anesthesia and analgesia
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