# Implementation of Pectointercostal Fascial Plane and Rectus Sheath Block as a Tool in Weaning From Mechanical Ventilation in Gripping Poststernotomy Pain: A Case Report

## TL;DR

This case report shows how combining two types of nerve blocks helped a patient recover from heart surgery and successfully stop using a ventilator.

## Contribution

The novel use of combined pectointercostal fascial plane and rectus sheath blocks is demonstrated to aid in weaning from mechanical ventilation.

## Key findings

- Combined nerve blocks reduced pain and improved ventilation in a post-surgery patient.
- The patient was successfully extubated after the blocks were administered.
- This approach reduced opioid use and supported weaning from mechanical ventilation.

## Abstract

Successful weaning from mechanical ventilation depends on many factors. Optimizing all factors creates the pathway of liberation from ventilation. Among them, comprehensive pain management is one of the most critical factors, especially for cardiac surgical patients, who require median sternotomy. This case report is about a case of a 55‐year‐old patient with diabetes mellitus, hypertension, and pneumonia, in whom weaning failed repeatedly after a coronary artery bypass graft operation and was successfully extubated after ultrasound‐guided implementation of a combined bilateral pectointercostal fascial plane block and rectus sheath block by reducing pain and improving ventilation, which was evidenced by reduced visual analog scale score and improvement of tidal volume. Integration of regional anesthesia not only provides adequate analgesia but also reduces opioid requirements and facilitates weaning, particularly for postcardiac surgical patients.