Bilateral Subpectoral Interfascial Plane Catheters for Analgesia for Sternal Fractures: A Case Report

Reg Anesth Pain Med. 2016 Sep-Oct;41(5):607-9. doi: 10.1097/AAP.0000000000000388.

Abstract

Objectives: Sternal fractures occur after deceleration injuries such as falls and road traffic accidents. Recovery from isolated fractures is excellent, but mortality increases dramatically with concurrent chest injuries such as rib fractures and soft tissue injuries. Short-term complications include chest pain, which prevents patients from taking deep breaths and coughing, thereby predisposing them to chest infections.

Case report: We present a case of a 73-year-old woman with sternal fracture in whom enteral analgesia was inadequate and who was intolerant to intravenous opiates.

Conclusions: The patient was successfully treated with a continuous infusion of local anesthetic into the subpectoral interfascial plane. We also discuss the use and potential benefits of the subpectoral interfascial plane block in the treatment of pain from sternal fractures.

Publication types

  • Case Reports

MeSH terms

  • Accidental Falls*
  • Aged
  • Anesthetics, Local / administration & dosage*
  • Bupivacaine / administration & dosage*
  • Chest Pain / diagnosis
  • Chest Pain / drug therapy*
  • Chest Pain / etiology
  • Female
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / etiology*
  • Humans
  • Nerve Block / methods*
  • Pain Management / methods*
  • Pain Measurement
  • Sternum / diagnostic imaging
  • Sternum / injuries*
  • Treatment Outcome
  • Ultrasonography, Interventional

Substances

  • Anesthetics, Local
  • Bupivacaine