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

• Published in: Clinical and experimental emergency medicine Vol. 7; no. 1; pp. 67 - 70
• Main Authors: Di Pietro, Santi, Mascia, Benedetta, Lo Bianco, Giuliano, Perlini, Stefano, Iotti, Giorgio Antonio
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Emergency Medicine 01-03-2020; 대한응급의학회
• Subjects: anesthesia and analgesia; Case Report; nerve block; rib fractures; sternum; 응급의학; Anesthesia and analgesia; Nerve block; Rib fractures; Sternum
• ISSN: 2383-4625; 2383-4625
• DOI: 10.15441/ceem.18.089

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.