The force-generating ability of the parasternal intercostals is maintained during acute hyperinflation in the dog (Jiang et al. Am. Rev. Respir. Dis. 139: 522-528, 1989). In the present studies, we assessed whether the ability of these muscles to expand the rib cage and inflate the lungs is really maintained. We thus measured the electromyogram and the changes in length of these muscles, the axial motion of the sternum and the ribs, and the changes in pleural pressure and tidal volume in anesthetized vagotomized phrenicotomized dogs during selective parasternal stimulation and during spontaneous breathing at different lung volumes corresponding to 0, 5, 10, and 15 cmH2O positive airway pressure. Compared with functional residual capacity, parasternal stimulation at 15 cmH2O positive airway pressure caused a mild decrease in muscle shortening, a large reduction in cranial rib motion, and a large reduction in pleural pressure fall. The caudal displacement of the sternum, however, was increased. Similar alterations in rib and sternal motions and in muscle shortening were seen during spontaneous breathing; tidal volume was markedly reduced as well. These observations thus indicate that hyperinflation affects the action of the parasternal intercostals on the rib cage; their rib-elevating action is decreased, whereas their action on the sternum is increased. As a result, their ability to inflate the lung is reduced. Thus, the inflationary actions of both the diaphragm and parasternal intercostals are reduced by hyperinflation.
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http://dx.doi.org/10.1152/jappl.1994.77.5.2201 | DOI Listing |
Cureus
December 2024
Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, USA.
Background and aim The study aimed to investigate the effect of adding perineural adjuvants, clonidine and dexamethasone, to local anesthetic in Superficial Parasternal Intercostal Plane (SPIP) blocks. It was designed as a prospective, randomized, triple-blinded, feasibility trial, conducted at a single-center university hospital. The participants included adult patients who were undergoing cardiac surgery via median sternotomy.
View Article and Find Full Text PDFPLoS One
December 2024
PneumoCardioVascular Lab/Hospital Universitário Onofre Lopes (HUOL), Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Am J Emerg Med
November 2024
Department of Emergency Medicine, Ospedale Sant'Anna, via Ravona 20, 22042, San Fermo della Battaglia (CO), Italy.
In uncomplicated sternal fractures, one of the first priorities is to treat pain in order to avoid secondary complications due to hospital admission or reduced mobility. We wanted to study the safety and the efficacy of ultrasound-guided superficial parasternal intercostal plane (SPIP) block in pain control in these kinds of patients in the emergency department (ED). SPIP block has proven to be a safe and practical technique in pain control in the operatory room e.
View Article and Find Full Text PDFCureus
October 2024
Department of Cardiovascular and Thoracic Surgery, King George's Medical University, Lucknow, IND.
Background: Transversus thoracis muscle plane block (TTPB) and parasternal intercostal nerve block (PICNB) inhibit the anterior branches of intercostal nerves and potentially provide adequate analgesia after cardiac surgery. This study aimed to compare these two blocks for a reduction in postoperative opioid consumption after cardiac surgery.
Methods: This randomized, single-blind trial included 60 adult cardiac surgical patients divided into three groups to receive ultrasound-guided TTPB (group T), PICNB (group P), or no block (group C) before surgery.
Curr Opin Anaesthesiol
February 2025
St Bartholomew's Hospital, London, UK.
Purpose Of Review: Acute postsurgical pain after cardiac surgery is challenging to treat. Adverse effects related to the high dose opioids which have traditionally been used perioperatively in cardiac surgery have led to the adoption of alternative analgesic strategies. This review aims to highlight current evidence-based approaches to managing pain after cardiac surgery.
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