Continuous serratus plane block in a patient with multiple rib fractures

Bossolasco, Matteo; Bernardi, Emanuele; Fenoglio, L.

doi:10.1016/j.jclinane.2016.12.015

Cited by 22 publications

(11 citation statements)

References 3 publications

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“…To overcome the short-lasting efficacy of SAPB, some authors have described the possibility of inserting a catheter into the SAPB space to allow continuous infusion of a local anesthetic for a predetermined time, after an initial bolus [ 14 , 24 , 25 ]. Such catheter insertion into the SAPB space for continuous ropivacaïne infusion could improve pain control during the first 48 h without opioid.…”

Section: Discussionmentioning

confidence: 99%

Serratus anterior plane block for minimal invasive heart surgery

Berthoud¹,

Ellouze²,

Nguyen³

et al. 2018

BMC Anesthesiol

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BackgroundMinimal invasive heart surgery (MIHS) presents several benefits, but provides intense and prolonged post-operative pain. Our objective was to compare efficacy of serratus anterior plane block (SAPB) with continuous wound infiltration (CWI) for management of post-operative pain following MIHS.MethodsIt’s retrospective, monocentric study between November 2016 to April 2017. The study was performed at the University hospital of Dijon, Burgundy, France. All patients scheduled for MIHS was included. Data was collected retrospectively. During this period, 20 patients had SAPB and 26 had CWI. SAPB was performed before extubation with a single injection of 0.5 mg/kg of ropivacaïne (5 mg/ml). In the CWI group, catheter was inserted in the subcutaneous space by the surgeon at the end of the procedure. A 10 ml bolus of ropivacaïne (7.5 mg/mL) was followed by a continuous infusion (2 mg/ml) between 7 and 12 ml/h for 48 h. Morphine consumption and visual analog score (VAS) were recorded for 48 h. Length of stay in intensive care unit and hospital was also collected.ResultsMorphine consumption and VAS score were significantly lower in SAPB group (p < 0.01). Length of stay in intensive care and hospital was significantly was decreased in SAPB group.ConclusionSAPB appears effective in reducing postoperative MIHS pain.Electronic supplementary materialThe online version of this article (10.1186/s12871-018-0614-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Serratus anterior plane block for minimal invasive heart surgery

Berthoud¹,

Ellouze²,

Nguyen³

et al. 2018

BMC Anesthesiol

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“…described the SPB technique in 2013, numerous studies have described SPB for postoperative pain management (eg, post‐thoracotomy or post‐mastectomy) with good results on analgesia without complications . Few case reports, however, have described SPB in blunt chest trauma with good analgesia effectiveness …”

Section: Discussionmentioning

confidence: 99%

“…24,25 Few case reports, however, have described SPB in blunt chest trauma with good analgesia effectiveness. [14][15][16][17][18][19] In this retrospective cohort, one complication occurred (perinervous catheter section). The patient was immediately informed.…”

Section: Discussionmentioning

confidence: 99%

“…described the serratus plane block (SPB) as a new technique for chest wall analgesia . While this technique has been widely studied in postoperative settings, there have been few clinical cases showing its utility in the management of rib fractures after blunt chest trauma . In these clinical cases, different conditions of use have been described: single injection, catheter placement with continuous injection, or catheter placement with repeated injections.…”

Section: Introductionmentioning

confidence: 99%

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Serratus Plane Block Is Effective for Pain Control in Patients With Blunt Chest Trauma: A Case Series

et al. 2019

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Background Rib fractures occur frequently following blunt chest trauma and induce morbidity and mortality. Analgesia is a cornerstone for their management, and regional analgesia is one of the tools available to reach this objective. Epidural and paravertebral blocks are the classical techniques used, but the serratus plane block (SPB) has recently been described as an effective technique for thoracic analgesia. Methods This case series reported and analyzed 10 consecutive cases of SPB for blunt chest trauma analgesia in a level 1 trauma center from May to October 2018. SPB was performed with either a single shot of local anesthetic or a catheter infusion. Results Ten patients were treated with 3 single shots and 7 catheter infusions (median length 3 days [interquartile range (IQR) 2.5 to 3.5]). The Median Injury Severity Score was 16 (IQR 16 to 23), and the number of broken ribs ranged from 3 to 22. Daily equivalent oral morphine consumption was significantly decreased after SPB from 108 mg (IQR 67 to 120) to 19 mg (IQR 0 to 58) (P = 0.015). The Numeric Pain Rating Scale (NPRS) score during cough was significantly decreased from 7.3 (IQR 5.3 to 8.8) to 4 (IQR 3.6 to 4.6) (P = 0.03). The NPRS score at rest remained unchanged. One complication occurred, due to a catheter section. Conclusions The SPB technique (with or without catheter insertion) in 10 patients who had blunt chest trauma with rib fractures is effective for cough pain control, with a significant decrease in morphine consumption.

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“…Oral and IV medications have been mainstays of management, and current studies have reported the benefits of epidural, paravertebral, and serratus plane analgesia for the treatment of rib fractures. [3][4][5][6] Research has explored intercostal nerve blocks for analgesia, but studies have questioned the potential benefit of this modality.…”

mentioning

confidence: 99%

Intercostal Nerve Block with Liposomal Bupivacaine vs Epidural Analgesia for the Treatment of Traumatic Rib Fracture

Sheets

Davis

Dirks

et al. 2020

Journal of the American College of Surgeons

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BACKGROUND: Rib fractures are common among trauma patients and analgesia remains the cornerstone of treatment. Intercostal nerve blocks provide analgesia but are limited by the duration of the anesthetic. This study compares outcomes of epidural analgesia with intercostal nerve block using liposomal bupivacaine for the treatment of traumatic rib fractures. METHODS: A retrospective chart review was used to identify patients who received either epidural analgesia or intercostal nerve block with liposomal bupivacaine for the treatment of traumatic rib fractures. Patients were matched in a 1:1 ratio on age, Injury Severity Score, and number of rib fractures. Outcomes included intubations, mechanical ventilation days, ICU length of stay (LOS), hospital LOS, and mortality. RESULTS: After matching, 116 patients were included in the study. Patients receiving intercostal nerve blocks with liposomal bupivacaine were less likely to require intubation (3% vs 17%; p ¼ 0.015), had shorter hospital LOS (mean AE SD 8 AE 6 days vs 11 AE 9 days; p ¼ 0.020) and ICU LOS (mean AE SD 2 AE 5 days vs 5 AE 6 days; p ¼ 0.007). There were no differences in ventilator days or mortality. Minor complications occurred in 26% of patients that received an epidural catheter for rib fractures. No complications occurred in the patients receiving intercostal nerve block. CONCLUSIONS: Patients who received intercostal nerve blocks with liposomal bupivacaine required intubation less frequently and had shorter ICU and hospital LOS compared with epidural analgesia patients. These results suggest that intercostal nerve blocks with liposomal bupivacaine might be equal or superior to epidural analgesia.

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Continuous serratus plane block in a patient with multiple rib fractures

Cited by 22 publications

References 3 publications

Serratus anterior plane block for minimal invasive heart surgery

Serratus anterior plane block for minimal invasive heart surgery

Serratus Plane Block Is Effective for Pain Control in Patients With Blunt Chest Trauma: A Case Series

Intercostal Nerve Block with Liposomal Bupivacaine vs Epidural Analgesia for the Treatment of Traumatic Rib Fracture

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