Abstract

Postoperative pain following median sternotomy is a major concern in cardiac surgery, contributing to delayed recovery, prolonged mechanical ventilation, extended intensive care unit (ICU) stays, and increased opioid use. Effective postoperative analgesia is essential to optimize recovery and minimize complications such as respiratory depression and chronic pain. Traditional opioid-based regimens, while effective for acute pain relief, are associated with significant adverse effects including nausea, vomiting, pruritus, delirium, constipation, and respiratory compromise. Emerging evidence supports the use of regional anesthesia techniques such as the parasternal intercostal plane (PIP) block as part of a multimodal analgesic approach to minimize opioid requirements. The PIP block, performed superficially or deep under ultrasound guidance, targets the anterior cutaneous branches of the intercostal nerves (T2–T6), providing localized sternal analgesia. Incorporating PIP blocks into multimodal cardiac anesthesia offers a safe, effective, and patient-centered strategy to reduce opioid reliance, enhance recovery, and improve overall surgical outcomes.

Author Details

Raleigh Mills, MSN, RN, CCRN | 4yrs of Pediatric ICU nursing experience | 3rd year SRNA; Maria Ledbetter, DNAP, CRNA, CNE

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Case Study/Series

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Parasternal Intercostal Block, Median Sternotomy, Opioid-Sparing Analgesia, Thoracic Surgery, Sternotomy, Postoperative Pain

Advisor

Maria Ledbetter

Degree

DNP

Degree Grantor

Samford University

Degree Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2026-01-29

Full Text of Presentation

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Additional Files

Abstract.pdf (154 kB)

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