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Title: Ultrasound guided parasternal modified intercostal nerve block: role as a preemptive analgesic adjunt in fast tracking for mitigating postoperative sternotomy pain
Authors: Santhosh V
Issue Date: Dec-2019
Publisher: SCTIMST
Abstract: Fear of uncontrolled pain is among the primary concerns of many patients who are about to undergo surgery. Pain affects patients physiological and psychological recovery (1). Adequate postoperative analgesia prevents unnecessary patient discomfort, may decrease morbidity, may decrease postoperative hospital lengths of stay, and thus may decrease costs. So aggressive implementation of well-planned pain management strategy is crucial for decreasing post-sternotomy pain and resultant morbidity and mortality in cardiothoracic surgeries (2)(3). Inadequate analgesia and/or an uninhibited stress response during the postoperative period may increase morbidity by causing adverse hemodynamic, metabolic, immunologic, and hemostatic alterations. Analgesic medication modalities, providing optimal relief from pain-anxiety, can facilitate early tracheal extubation, with minimal compromise on airway-reflexes during post-tracheal extubation period after cardiac surgery. This would result in optimal patient comfort-satisfaction without any post-operative pain (4).Also in the recent years, a multimodal approach utilizing combined regional and systemic analgesics with different mechanisms of action has been found to be promising and beneficial in terms of treating acute pain and preventing chronic pain after cardiac surgery. Pre-emptive analgesia execution assumes a critical role in blunting traumatic or surgical damage induced stimulus modification in both peripheral and central nervous system, and therefore this modality must be considered during the decision making of preoperative analgesic techniques (5)(6).
Appears in Collections:Anaesthesia

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