How I Do It: Transversus Thoracic Plane and Pecto-Intercostal Fascial Block

May 2020 Issue

  1. Renuka George, MD Assistant Professor, Medical University of South Carolina Co-author
  2. Kirsten Dahl, MD Resident, Clinical Anesthesia–3, Regional Anesthesia Fellow 2019–2020, Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina Co-author
  3. Johanna Blair de Haan, MD Assistant Professor, McGovern Medical School, UT Health at Houston Co-author


This article originally appeared in the November 2019 issue of ASRA News.


The opioid crisis currently threatening the health of the global population has compelled health care providers to reconsider appropriate analgesic options. Massive efforts have been made to maximize multimodal analgesia and regional anesthetic techniques to reduce pain and the need for opioid analgesics. In turn, ultrasound imaging technology has improved and interest in anatomical study has renewed, proliferating fascial plane blocks to assist in the provision of perioperative analgesia.


Treating surgical chest pain adequately and in a manner that minimizes the requirement for significant opioid administration is important.


Although the notion of pain as the fifth vital sign now appears misguided, postsurgical pain limits recovery and may increase the risk of perioperative morbidity. Poorly managed chest wall pain may increase incidence of pulmonary complications because of the need for splinting. Restricted postoperative breathing can result in hypoventilation, atelectasis, pneumonia, and an increased length of hospital stay. Thus, treating surgical chest pain adequately and with minimal opioid administration is important.

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Tags: transversus thoracic plane, pecto-intercostal fascial block

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Transversus Thoracic Plane Block: How I Do It
ASRA News, Nov 1, 2019 - Renuka George, MD; Kirsten Dahl, MD; Johanna Blair de Haan, MD