Ultrasound-Guided Analgesia in Cardiac and Breast Surgeries: A Cadaveric Comparison of SPIP Block with Single and Double Injections vs. DPIP Block
The evolution of regional anesthesia techniques has markedly influenced the management of postoperative pain, particularly in thoracic surgery. As part of a multimodal analgesic approach, fascial plane blocks have gained prominence due to their efficacy in providing targeted analgesia with minimal s...
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2024-12-01
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| author | Carmelo Pirri Debora Emanuela Torre Astrid Ursula Behr Veronica Macchi Andrea Porzionato Raffaele De Caro Carla Stecco |
| author_facet | Carmelo Pirri Debora Emanuela Torre Astrid Ursula Behr Veronica Macchi Andrea Porzionato Raffaele De Caro Carla Stecco |
| author_sort | Carmelo Pirri |
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| description | The evolution of regional anesthesia techniques has markedly influenced the management of postoperative pain, particularly in thoracic surgery. As part of a multimodal analgesic approach, fascial plane blocks have gained prominence due to their efficacy in providing targeted analgesia with minimal systemic side effects. Among these, the superficial intercostal plane (SPIP) block and deep parasternal intercostal plane (DPIP) block are of notable interest. The aim of this study was to investigate the dye spread to the anterior chest wall space and its spread pathway through anatomical morphometric analyses on cadavers for single-injection and double-injection SPIP blocks versus DPIP blocks. In both qualitative and quantitative evaluations, the single-injection SPIP block with 10 mL of dye demonstrated a broader and more extensive spread compared to the double-injection SPIP block, which used 5 mL of dye per injection site (<i>p</i> < 0.05), and the DPIP block with 10 mL of dye (<i>p</i> < 0.05). All the blocks had a positive correlation between the distances from the sternum border and the area of dye spread, suggesting that the crucial role of volume in fascial blocks is that it significantly affects the opening of the fascial compartment, enabling optimal spread of the anesthetic. Adequate volume facilitates proper spread and diffusion across the fascial plane, ensuring more comprehensive fascia coverage and thus enhancing the block’s effectiveness. Finally, precise volume management is key to maximizing both efficacy and safety. |
| format | Article |
| id | doaj-art-945fb3471c0a43ee9c998bfe4b6e1e86 |
| institution | Kabale University |
| issn | 2075-1729 |
| language | English |
| publishDate | 2024-12-01 |
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| spelling | doaj-art-945fb3471c0a43ee9c998bfe4b6e1e862025-01-24T13:38:33ZengMDPI AGLife2075-17292024-12-011514210.3390/life15010042Ultrasound-Guided Analgesia in Cardiac and Breast Surgeries: A Cadaveric Comparison of SPIP Block with Single and Double Injections vs. DPIP BlockCarmelo Pirri0Debora Emanuela Torre1Astrid Ursula Behr2Veronica Macchi3Andrea Porzionato4Raffaele De Caro5Carla Stecco6Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, ItalyDepartment of Cardiac Anesthesia and Intensive Care Unit, Cardiac Surgery, Ospedale dell’Angelo, 30174 Venice Mestre, ItalyDepartment of Anesthesia and Intensive Care, ULSS 6 Euganea Padova, Camposampiero Hospital, 35012 Camposampiero, ItalyDepartment of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, ItalyDepartment of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, ItalyDepartment of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, ItalyDepartment of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, ItalyThe evolution of regional anesthesia techniques has markedly influenced the management of postoperative pain, particularly in thoracic surgery. As part of a multimodal analgesic approach, fascial plane blocks have gained prominence due to their efficacy in providing targeted analgesia with minimal systemic side effects. Among these, the superficial intercostal plane (SPIP) block and deep parasternal intercostal plane (DPIP) block are of notable interest. The aim of this study was to investigate the dye spread to the anterior chest wall space and its spread pathway through anatomical morphometric analyses on cadavers for single-injection and double-injection SPIP blocks versus DPIP blocks. In both qualitative and quantitative evaluations, the single-injection SPIP block with 10 mL of dye demonstrated a broader and more extensive spread compared to the double-injection SPIP block, which used 5 mL of dye per injection site (<i>p</i> < 0.05), and the DPIP block with 10 mL of dye (<i>p</i> < 0.05). All the blocks had a positive correlation between the distances from the sternum border and the area of dye spread, suggesting that the crucial role of volume in fascial blocks is that it significantly affects the opening of the fascial compartment, enabling optimal spread of the anesthetic. Adequate volume facilitates proper spread and diffusion across the fascial plane, ensuring more comprehensive fascia coverage and thus enhancing the block’s effectiveness. Finally, precise volume management is key to maximizing both efficacy and safety.https://www.mdpi.com/2075-1729/15/1/42analgesiacardiac surgeryfasciaSPIP blockDPIP blockUS-guided techniques |
| spellingShingle | Carmelo Pirri Debora Emanuela Torre Astrid Ursula Behr Veronica Macchi Andrea Porzionato Raffaele De Caro Carla Stecco Ultrasound-Guided Analgesia in Cardiac and Breast Surgeries: A Cadaveric Comparison of SPIP Block with Single and Double Injections vs. DPIP Block Life analgesia cardiac surgery fascia SPIP block DPIP block US-guided techniques |
| title | Ultrasound-Guided Analgesia in Cardiac and Breast Surgeries: A Cadaveric Comparison of SPIP Block with Single and Double Injections vs. DPIP Block |
| title_full | Ultrasound-Guided Analgesia in Cardiac and Breast Surgeries: A Cadaveric Comparison of SPIP Block with Single and Double Injections vs. DPIP Block |
| title_fullStr | Ultrasound-Guided Analgesia in Cardiac and Breast Surgeries: A Cadaveric Comparison of SPIP Block with Single and Double Injections vs. DPIP Block |
| title_full_unstemmed | Ultrasound-Guided Analgesia in Cardiac and Breast Surgeries: A Cadaveric Comparison of SPIP Block with Single and Double Injections vs. DPIP Block |
| title_short | Ultrasound-Guided Analgesia in Cardiac and Breast Surgeries: A Cadaveric Comparison of SPIP Block with Single and Double Injections vs. DPIP Block |
| title_sort | ultrasound guided analgesia in cardiac and breast surgeries a cadaveric comparison of spip block with single and double injections vs dpip block |
| topic | analgesia cardiac surgery fascia SPIP block DPIP block US-guided techniques |
| url | https://www.mdpi.com/2075-1729/15/1/42 |
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