Operative anesthetic requirements and perioperative discomfort are barriers to wide adoption of the subcutaneous implantable cardioverter–defibrillator (SICD) system. The SICD implant procedure involves incision and dissection in the richly innervated midaxillary line of the chest wall for placement of the pulse generator and tunneling in subcutaneous tissue for implantation of the defibrillator lead.1 Intraoperative local anesthetic wound infiltration is routine and provides moderate analgesia, but the effects are short-lasting, and complete coverage of the affected areas is difficult.
Operative anesthetic requirements and perioperative discomfort are barriers to wide adoption of the subcutaneous implantable cardioverter–defibrillator (SICD) system. The SICD implant procedure involves incision and dissection in the richly innervated midaxillary line of the chest wall for placement of the pulse generator and tunneling in subcutaneous tissue for implantation of the defibrillator lead.1 Intraoperative local anesthetic wound infiltration is routine and provides moderate analgesia, but the effects are short-lasting, and complete coverage of the affected areas is difficult.