• Kexin Yuan, Boqun Cui, Duomao Lin, Haiyan Sun, and Jun Ma.
• Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
• J. Cardiothorac. Vasc. Anesth. 2025 Jan 8.

AbstractMinimally invasive cardiac surgery (MICS) often leads to severe postoperative pain. At present, multimodal analgesia schemes for MICS have attracted much attention, and the application of various chest wall analgesia techniques is becoming increasingly widespread. However, research on anesthesia techniques for postoperative pain management in MICS remains relatively limited at present. We searched for relevant literature and summarized recent related research in eight MICS techniques, including thoracic epidural anesthesia, spinal anesthesia, thoracic paravertebral plane block, erector spinae plane block, serratus anterior plane block, pectoral nerve block, intercostal nerve block, and parasternal block. This article provides an overview of the anatomy and procedures involved in these analgesic techniques, their mechanisms of action, and the latest clinical trial evidence. It also evaluates their progress in MICS, compares their advantages and disadvantages, and discusses practical challenges.Copyright © 2025 Elsevier Inc. All rights reserved.

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