# Awake Thoracotomy in an Obese Case of Cardiac Tamponade: A Case Report

## TL;DR

This case report describes an awake thoracotomy procedure in an obese patient with cardiac tamponade using specific local analgesia techniques.

## Contribution

The paper presents the first known use of parasternal and serratus anterior blocks for awake thoracotomy in a patient with cardiac tamponade.

## Key findings

- Awake thoracotomy was successfully performed using serratus anterior and parasternal blocks.
- The case highlights the use of local analgesia in managing a high-risk obese patient with cardiac and respiratory issues.

## Abstract

Introduction: Awake thoracic surgery is an old procedure still being used to this day for various indications, utilizing many different techniques for local analgesia.

Case Presentation: We described the case of a 60-year-old obese heavy smoker, with significant respiratory and cardiac morbidity, who presented with signs of cardiac tamponade secondary to hypothyroidism. Our patient was treated with a pericardial window, using serratus anterior and parasternal blocks.

Discussion: We presented the first case to our knowledge that employed parasternal and serratus anterior blocks as local analgesia for an awake thoracotomy, we also discussed different techniques, indications, benefits, and complications.