Fascial plane blocks for cardiothoracic surgery: a narrative review

Table 1 Fascial plane blocks for cardiothoracic surgery and their indications

Block	Target	Indication	Highest level of evidence
SPIP/DPIP	Anterior cutaneous branches from T2 to T6 intercostal nerves	Median sternotomy S-ICD implantation (with SAPB)	Level I Level IV
PECS I–II	Medial and lateral pectoral nerves, lateral cutaneous branches of intercostal nerves (T2–T7), long thoracic and thoracodorsal nerves	Thoracotomy VATS surgery Median sternotomy Mini-invasive MV surgery S-ICD implantation Trans-subclavian TAVI	Level II Level IV Level II Level II Level IV Level V
SAPB	Lateral cutaneous branches of intercostal nerves (T3–T8), long thoracic and thoracodorsal nerves	VATS surgery Mini-invasive MV surgery S-IDC implantation	Level I Level II Level IV
ESPB	Ventral and dorsal ramus of the thoracic spinal nerve, lateral cutaneous branches of intercostal nerves (T2–T8)	VATS surgery and open thoracotomy Mini-invasive MV surgery	Level I Level II

SPIP Superficial parasternal intercostal plane block, DPIP Deep parasternal intercostal plane block, SAPB Serratus anterior plane block, ESPB Erector spinae plane block, VATS Video-assisted thoracic surgery, MV Surgery Mitral valve surgery, S-IDC Subcutaneous implantable cardioverter-defibrillator; level of evidence were assigned as defined by the Oxford Centre for Evidence-Based Medicine [6]

ISSN: 2731-3786