Recto-intercostal fascial plane block: Another novel fascial plane block

Abstract

Superficial and deep parasternal intercostal plane blocks are preferable options as fascial plane blocks in parasternal region surgeries. These techniques aim to block the anterior cutaneous branches of T2-T6 thoracic nerves. However, with these blocks, it is impossible to block the T7 and lower anterior cutaneous branches and the lateral cutaneous branches of the thoracoabdominal nerves [1]. In cardiac surgeries with median sternotomy, mediastinal tube placement sites are outside the parasternal block effect area, and sometimes the sternotomy incision extends below the T6 dermatome. Generally, surgeons apply LA infiltration to tube entry points for analgesia. In cases where sternum revision is required -if awake surgery is preferred- parasternal blocks alone are not sufficient, clinicians seek complementary techniques (such as pectoralis-intercostal rectus sheath (PIRS) plane block).