Sternal haematoma infusion catheter: a novel technique for pain management in manubriosternal fractures in the emergency department.
K FrowdeSalman NaeemA AlzarradD Abdel-AzizO W SchofieldPublished in: Anaesthesia reports (2024)
Sternal fractures are associated with significant morbidity and mortality, with some patients requiring admission for pain management, often through systemic analgesia, which may be ineffective. Regional anaesthetic techniques are more challenging for sternal fractures than rib fractures and require experienced clinicians. Local anaesthetic techniques are becoming recognised as a modality to improve pain control and to reduce complications from opioid use, especially in the elderly. We delivered local anaesthetic via a sternal haematoma infusion catheter for an elderly patient with uncontrolled pain despite the provision of intravenous patient-controlled analgesia. This technique enabled an improvement in pain scores, better engagement with physiotherapy and reduced opioid use. Local anaesthesia has been used previously to manage pain after coronary artery bypass graft surgery. Our experience demonstrated the safety, efficacy and tolerability of this approach to analgesia in sternal fractures.
Keyphrases
- pain management
- chronic pain
- coronary artery bypass
- emergency department
- end stage renal disease
- ejection fraction
- minimally invasive
- palliative care
- newly diagnosed
- social media
- percutaneous coronary intervention
- middle aged
- chronic kidney disease
- risk factors
- open label
- prognostic factors
- peritoneal dialysis
- spinal cord injury
- coronary artery disease
- study protocol
- postoperative pain