Superficial Parasternal Intercostal Plane Block for Pain Control Following Thymectomy via Midline Sternotomy: A Case Report

We report a case of a 53-year-old male with myasthenia gravis who underwent thymectomy via a full-length median sternotomy. To minimize opioid exposure and enhance postoperative recovery, a bilateral ultrasound-guided superficial parasternal intercostal plane (S-PIP) block was administered using 15 mL of 0.25% bupivacaine on each side before incision. Postoperative analgesia was maintained with paracetamol and dexketoprofen. No systemic opioids were required, and pain scores remained below 4 during the first 24 hours. The patient recovered uneventfully in the postoperative period. This case highlights the utility of S-PIP block as a safe and opioid-sparing technique in high-risk patients undergoing sternotomy.