Arun Kalava, MD, FASA, EDRA
Breakthru Acute Pain & Ketamine Clinic,
Case: Ultrasound Guided Pecto-intercostal Nerve Block
Featured Product: Envision Pad
A 42-year-old male veteran presented with severe sternal pain from a sternotomy for an intrathoracic tumor fifteen years ago. As a result, he suffered from allodynia, or nerve-related skin sensitivity, causing extreme pain. The patient failed opioid therapy. A spinal cord stimulator was also utilized as a form of treatment and worked briefly, but it was ultimately removed due to MRSA infection. An ultrasound-guided pecto-intercostal nerve block was the next step in his pain management.
For this patient with chronic post sternotomy pain, the bilateral blocks resulted in 100% pain relief. Ultrasound guidance using the Envision Ultrasound Scanning Pad is currently being utilized to administer phenol and alcohol chemoneurolysis for treatment with variable pain relief of 30-50%.