Intertransverse Process Block in Coronary Bypass Surgery: A Two-Case Report

Abstract

Severe postoperative pain following coronary artery bypass grafting (CABG) performed via median sternotomy can adversely affect early mobilization, respiratory function, and overall recovery. Therefore, achieving effective analgesia is of paramount importance to prevent postoperative complications and enhance patient comfort. In recent years, regional anesthesia techniques have become an integral component of multimodal analgesia protocols due to their potential to reduce opioid consumption and improve analgesic efficacy.

In this case series, bilateral intertransverse process block (ITPB) was performed under ultrasound guidance prior to surgery in two patients scheduled for elective CABG. Following the block, both patients were observed to have low pain scores, minimal opioid consumption, and no requirement for rescue analgesia throughout the postoperative period. No complications were encountered, and both patients were mobilized early with high-quality recovery scores.

These cases demonstrate that ITPB may be a safe, feasible, and effective method for managing acute postoperative pain following median sternotomy. Particularly in patients where more invasive techniques such as thoracic epidural block are contraindicated or technically challenging, ITPB may serve as a strong alternative. In this context, ITPB should be considered more routinely in postoperative analgesia protocols for cardiac surgery.