Transversus Thoracic Muscle Plane Block for Attenuating the Haemodynamic Response to Median Sternotomy: A Case Series

With the emergence of opioid-sparing and enhanced recovery pathways, cardiac anaesthesiologists are highly motivated to formulate regional analgesia-centric multimodal regimes, particularly prompted by the inclusion of safer fascial plane blocks to the analgesic repertoire. Ahead of the encouraging literature on perioperative pain relief with the thoracic fascial plane blocks, the fraternity continues to search for promising options for ensuring sternal analgesia. While the novel transversus thoracic muscle plane block emerges as the recent kid on the block for effective sternal analgesia (in the most anatomical sense of the matter), the sporadic case reports and feasibility studies primarily focus on an overall perioperative analgesic role of the block. The index case series describes a noteworthy experience with a pre-induction transversus thoracic muscle plane block administration for attenuating the intraoperative (particularly, median sternotomy) haemodynamic response in adult cardiac surgical patients, with a potential to translate into reduced perioperative fentanyl requirement, augmented recovery, and fast-tracking.