Rectus Sheath Block for Pain Management in Subxiphoid Single-Incision Thoracoscopic Surgery

Subxiphoid video-assisted thoracoscopic surgery (VATS) procedures have been shown to cause less postoperative pain compared to that caused by intercostal VATS. New approaches have been investigated to prevent surgery or chest tube pain. We performed a middle lobe wedge resection for a solitary pulmonary nodule via a uniportal subxiphoid VATS approach. An ultrasound-guided rectus sheath block (US-RSB) was performed after the procedure. The patient recovered well with a numeric pain score of 1/10 and was discharged on the postoperative first day without complications. There was no need for opioid agents perioperatively. This report is the first to use a rectus sheath block to prevent postoperative pain in subxiphoid VATS.