Use of Envision Scanning Pad During an Ultrasound Guided Pecto-intercostal Nerve Block

CONSIDERATION FOR USE

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.

REQUIRED EQUIPMENT FOR EXAMINATION

• SonoSite Edge II ultrasound system, Linear high frequency probe
• CIVCO Envision^â„¢ Ultrasound Scanning Pad with sterile saline used as a couplant

ADVANTAGES OF USING ENVISION IN THIS PROCEDURE

• Envision Ultrasound Scanning Pad is sterile.
• Firm grip (non-skid) of the probe over the chest wall, as the chest has an uneven surface due to the ribs.
• Increased patient satisfaction and improved clean-up workflow due to not using gel. The patient had extreme sensitivity due to allodynia and wiping of gel may have been more painful.

PATIENT SATISFACTION POST-PROCEDURE

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%.

Image of the procedure showing the Envision Ultrasound Scanning Pad on the ultrasound transducer and no gel on the patient's skin for minimal cleanup.

Quality ultrasound image showing needle placement