Regional analgesia of the anterior thorax in cardiac surgery: Case series

Introduction: Postoperative pain relief is essential in anesthetic practice. Regional analgesia is an emerging tool, and its performance has drawn interest among the cardiac surgical population. Objective: To describe the benefits and safety of regional analgesia of the anterior thorax in cardiac surgery. Methods: A case series study including records of adult patients undergoing cardiac surgery between July 1, 2024, and January 31, 2025, who received superficial parasternal intercostal plane block (SPIPB) or interpectoral/pectoserratus block (PECS II). Postoperative opioid requirements during the first 48 hours, time to extubation, and length of stay in the intensive care unit (ICU) were described. Results: Data from 60 patients were included, of whom 88.3% received SPIPB and 11.7% PECS II. The median ICU stay was three days, and extubation occurred at 180 minutes. Hydromorphone consumption was 0.1, 0.4, 0.7, and 0.8 mg at 6, 12, 24, and 48 hours, respectively. Hydromorphone consumption was higher in overweight and obese patients. Forty-two patients had extracorporeal circulation times under 90 minutes and were extubated within six postoperative hours. Postoperative complications were rare, with none related to regional analgesia.