&lt;p&gt;Effects of serratus anterior plane block for postoperative analgesia after thoracoscopic surgery compared with local anesthetic infiltration: a randomized clinical trial&lt;/p&gt;

Chen, Guodong; Li, Yufang; Yi-xiao, Zhang; Fang, Xiangming

doi:10.2147/jpr.s207116

Cited by 46 publications

(60 citation statements)

References 22 publications

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“…The incidence of side effects such as nausea and vomiting is significantly lower as well [11]. Chen et al demonstrated that SAP blocks provided superior analgesic effect, where pain scores and opioid consumption were significantly lower in the postoperative period [2]. Either of our patients did not require intraoperative opioid use, except when given as rescue analgesia in patient 2.…”

Section: Discussionmentioning

confidence: 53%

“…Using USG, the anterior serratus muscle appears as a thick hypoechoic appearance below the latissimus dorsi muscle and above the rib cage [5]. To date, there are still no definitive criteria for optimal volume and concentration for local anesthetic in SAP blocks [2]. In this study, SAP block was performed using roughly 0.4 ml/kg of long-acting local anesthetic.…”

Section: Discussionmentioning

confidence: 99%

“…Effective pain management is one of the crucial components in enhanced recovery after surgery (ERAS). Thus, the selection of appropriate analgesia modalities is needed [2].…”

Section: Introductionmentioning

confidence: 99%

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Serratus anterior plane block in modified radical mastectomy surgery: a case series

Datu

Prasetyadhi

2020

JA Clin Rep

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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.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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Serratus anterior plane block in modified radical mastectomy surgery: a case series

Datu

Prasetyadhi

2020

JA Clin Rep

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“…34 Compared to local anesthetic infiltration, SAPB led to better pain relief and lower opioid consumption after VATS. 35 Kim et al reported that SAPB can be used as the main component of multimodal analgesia for patients undergoing VATS rather than as a direct alternative to PVB or TEB due to the lower pain intensity and the shorter time of analgesia. 36 Abdallah et al confirmed that ultrasound-guided SAPB with 1 µg/kg DEX was safe and effective for patients undergoing VATS; however, only one dose of DEX was assessed.…”

Section: Discussionmentioning

confidence: 99%

<p>The Safety and Efficacy of Ultrasound-Guided Serratus Anterior Plane Block (SAPB) Combined with Dexmedetomidine for Patients Undergoing Video-Assisted Thoracic Surgery (VATS): A Randomized Controlled Trial</p>

Liu

Zhao

et al. 2020

JPR

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Background: Although video-assisted thoracic surgery (VATS) can significantly reduce postoperative pain, the incidence is as high as 30-50%. The purpose of this study was to explore the safety and efficacy of ultrasound-guided serratus anterior plane block (SAPB) combined with dexmedetomidine (Dex) for patients undergoing VATS. Methods: Eighty patients were randomized into two groups (20 mL 0.5% ropivacaine plus 0.5 µg/kg or 1 µg/kg Dex). Primary outcome was the visual analog scale of pain while coughing (VASc) score at 24 h after surgery. Secondary outcomes included hemodynamics, sufentanil consumption, number of patients needing rescue analgesia, time to first rescue analgesic, total dose of rescue analgesic, satisfaction scores of patients and surgeons, time of chest tube removal, length of hospital stay, adverse effects, the prevalence of chronic pain and quality of life. Results: Compared with D1 group, visual analog scale of pain at rest (VASr) was significantly lower during the first 24 h after surgery, while VASc was significantly lower during the first 48 h after surgery (P<0.05). Mean arterial pressure was significantly decreased from T2 to T8, and heart rate was significantly decreased from T2 to T7 in the D2 group (P<0.05). Consumption of sevoflurane, remifentanil, DEX and the recovery time were significantly reduced in the D2 group (P <0.05). Consumption of sufentanil 8-72 h after surgery was significantly lower in the D2 group (P<0.05). Additionally, the number of patients who required rescue analgesia, the time to the first dose of rescue analgesia, and the total dose of rescue analgesia was significantly lower in the D2 group (P<0.05). Conclusion: The results of this study show that 1 µg/kg DEX is a beneficial adjuvant to ropivacaine for single-injection SAPB in VATS patients while stable hemodynamics were maintained.

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“…One group reported that serratus anterior plane block could provide optimal analgesia for chest tube-related pain. 48 Thirdly, we did not record the amount of ropivacaine although no P group patients suffered from local anesthetic toxicity-related complications. Fourthly, we used 0.3 μg/kg dexmedetomidine in addition to ropivacaine based on previous studies, a dose-response study was not performed to confirm the optimum dexmedetomidine dose.…”

Section: Pain At Restmentioning

confidence: 98%

<p>The Efficacy and Safety of Paravertebral Block Combined with Parecoxib During Video-Assisted Thoracic Surgery: A Randomized Controlled Trial</p>

Yang¹,

Hao²,

Li³

et al. 2020

JPR

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Background: Although video-assisted thoracoscopic surgery (VATS) is increasingly used, the optimal analgesia strategy is still unknown. We explore the efficacy and safety of preemptive ultrasound-guided paravertebral block (PVB) combined with parecoxib during VATS. Methods: Seventy-four patients were divided into two groups. PVBs were performed before anesthesia induction under real-time ultrasound guidance. Visual analog scale (VAS) score with coughing at 48 h after surgery, postoperative sufentanil consumption and level of sedation (LOS) at 1, 4, 8, 12, 24, and 48 h postoperatively, intraoperative hemodynamics, satisfaction scores of patients and surgeons, remedial measures, time to chest tube removed and mobilization, adverse effects and hospital stay length were recorded. We also recorded inflammatory markers, respiratory function and the prevalence of chronic pain after surgery. Results: VAS scores at rest and with coughing during the first 24 h after surgery were significantly lower in the P group (P<0.05). Consumption of sevoflurane, remifentanil, and dexmedetomidine was all significantly reduced in the P group (P<0.05). The consumption of sufentanil within 48 h after surgery, time to first dose and total dose of rescue ketorolac was significantly lower in the P group (P<0.05). The FEV1/FVC ratio was significantly higher in the P group at 1 and 3 d after surgery (P<0.05). Times to chest tube removal and mobilization were significantly shorter in the P group (P<0.05). Compared with the C group, the level of both ACTH and cortisol was significantly reduced in the P group at 1 and 3 d after surgery (P<0.05). Conclusion: PVB combined with parecoxib was associated with better pain relief, decreased sufentanil and ketorolac consumption, less hemodynamic instability, and a lower surgery-related stress response. However, the incidences of chronic pain 3 and 6 months after surgery and the risk of complication except urinary retention were not significantly different between groups.

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<p>Effects of serratus anterior plane block for postoperative analgesia after thoracoscopic surgery compared with local anesthetic infiltration: a randomized clinical trial</p>

Cited by 46 publications

References 22 publications

Serratus anterior plane block in modified radical mastectomy surgery: a case series

Serratus anterior plane block in modified radical mastectomy surgery: a case series

<p>The Safety and Efficacy of Ultrasound-Guided Serratus Anterior Plane Block (SAPB) Combined with Dexmedetomidine for Patients Undergoing Video-Assisted Thoracic Surgery (VATS): A Randomized Controlled Trial</p>

<p>The Efficacy and Safety of Paravertebral Block Combined with Parecoxib During Video-Assisted Thoracic Surgery: A Randomized Controlled Trial</p>

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