The patient had chest pain for 2 years, all the tests for suspected myocardial ischaemia were negative (cardiac enzyme profile, troponin, ECG), we looked at the patient's chest CT and observed strong echoes in the middle of the sternum, and considered aseptic inflammation, we performed bilateral transverse thoracic muscle plane block under ultrasound guidance for 4 times, the patient's pain was significantly improved, but considering that the patient was already menopausal and couldn't be on too many hormones, we had the patient's remaining pain, the Methylcobalamin injection alone was given temporarily. Supplemented with floating needle electrotherapy, what treatment experience can you share?
Post - sternotomy pain are usually neuropathic in nature . Epidural Thoracic Anaesthesia might be good for such type of pain and provide excellent analgesia but may be cumbersome for patients to carry it for prolong duration. Pectointercostal nerve nerve may be option besides Transverse thoracic muscle nerve block . We can prolong analgesia by adding adjuvants like dexamethasone, fentanyl to parasternal nerve block . apart from nerve block , we can pregabalin or gabapentin for neuropathic pain
Post - sternotomy pain are usually neuropathic in nature . Epidural Thoracic Anaesthesia might be good for such type of pain and provide excellent analgesia but may be cumbersome for patients to carry it for prolong duration. Pectointercostal nerve nerve may be option besides Transverse thoracic muscle nerve block . We can prolong analgesia by adding adjuvants like dexamethasone, fentanyl to parasternal nerve block . apart from nerve block , we can pregabalin or gabapentin for neuropathic pain
Post- sternotomy pain are usually neuropathic many modalities are available among them thoracic epidural is still Gold standard Oral Pregabalin is frequently used for such type pf pain
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