Background Postoperative breast pain may lead to poorer outcome if left untreated. Common analgesia modalities for postoperative breast pain include opioids and regional anesthesia. However, both of these modalities can cause significant side effects or complications. Serratus anterior plane (SAP) block is a new procedure that is relatively easier to perform and safer, compared with other modalities. Previous studies have reported its usefulness in reducing the need for both intraoperative and postoperative opioids. Case We reported 2 patients that underwent SAP block combined with general anesthesia in modified radical mastectomy (MRM). Patient 2 was given rescue analgesia during the intraoperative period. The administration of postoperative opioids did not exceed 24 h in both patients. Pain assessment using numeric rating scale (NRS) showed minimal postoperative pain. No side effects were found during 24-h monitoring period. Conclusion SAP block can be used as one of the modalities in managing the pain of MRM surgery.

Postoperative breast pain may lead to poorer outcome if left untreated. Common analgesia modalities for postoperative breast pain include opioids and regional anesthesia. However, both of these modalities can cause significant side effects or complications. Serratus anterior plane (SAP) block is a new procedure that is relatively easier to perform and safer, compared with other modalities. Previous studies have reported its usefulness in reducing the need for both intraoperative and postoperative opioids. We report two patients who underwent SAP block combined with general anesthesia in modified radical mastectomy (MRM). Patient 2 was given rescue analgesia during the intraoperative period. The administration of postoperative opioids did not exceed 24 h in both patients. Pain assessment using Numeric Rating Scale showed minimal postoperative pain. No side effects were found during 24-h monitoring period. SAP block can be used as one of the modalities in managing the pain of MRM surgery.

Background: Effective postoperative multimodal analgesia facilitates early physical rehabilitation to maximize the postoperative range of motion and prevent joint adhesions following total knee arthroplasty (TKA). Adductor canal block has been reported as a supplement to multimodal analgesia protocols in patients undergoing TKA. The use of ultrasound (US) guidance has improved the success rates of the blocks compared with blind approaches. Case Presentation: This report described two elderly patients undergoing TKA with ACB as postoperative pain management, resulting in adequate pain control during the postoperative period. Conclusion: Adductor canal block can be used to optimize multimodal analgesia by reducing opioid requirements and enhancing recovery after TKA.

Latar belakang:Nyeri pascaoperasi payudara dapat memperburuk keluaran klinis jika tidak ditangani dengan optimal. Modalitas analgesia yang biasa digunakan untuk nyeri pascaoperasi payudara meliputi pemberian opioid dan anestesi regional. Namun, kedua modalitas ini dapat menimbulkan efek samping atau komplikasi yang signifikan. Blok serratus anterior plane (SAP) merupakan prosedur baru yang relatif lebih mudah dilakukan dan aman bila dibandingkan dengan modalitas lainnya.Kasus: Kami melaporkan 2 pasien yang menjalani prosedur blok SAP pada operasi modified radical mastectomy (MRM). Pasien 2 diberikan rescue analgesia selama masa intraoperatif. Pemberian opioid pascaoperasi tidak melebihi 24 jam pada kedua pasien. Penilaian nyeri menggunakan Numeric Rating Scale (NRS) menunjukkan nyeri pascaoperatif yang minimal. Tidak ada efek samping yang ditemukan selama masa pemantauan 24 jam.Pembahasan: Blok SAP relatif mudah dilakukan, memiliki tingkat keberhasilan yang tinggi, dan komplikasi minimal jika dibandingkan dengan prosedur lain. Blok SAP memberikan efek analgesia pada thoraks bagian lateral yang dapat bertahan hingga 12 jam pascaoperasi. Studi-studi terdahulu telah melaporkan kegunaannya dalam mengurangi kebutuhan opioid intraoperatif dan pascaoperatif, yang sesuai dengan hasil yang ditemukan pada laporan kasus ini.Kesimpulan: Blok SAP dapat menjadi salah satu modalitas yang efektif dan aman dalam mengelola nyeri pasien yang menjalani operasi MRM.