Rhomboid intercostal and subserratus plane block for non-intubated video-assisted thoracoscopic surgery

Longo, Ferdinando; Piliego, Chiara

doi:10.1016/j.jclinane.2019.09.006

Cited by 5 publications

(7 citation statements)

References 3 publications

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“…They used 15 ml of 0.375% ropivacaine injection in T5-6 and 15 ml of 0.375% ropivacaine injection in T8-9, and at the 1-h and 4-h postoperative evaluation, the patients remained comfortable and pain-free without the need for additional pain medications. Our findings are similar to those of Longo et al [13]. The RISS block showed better analgesic effects after thoracic surgery, and the NRS scores were maintained at ≤ 3/10 within 24 h after the surgery, and few analgesic remedies were required.…”

Section: Discussionsupporting

confidence: 91%

“…We speculate that the reason for the longer duration of analgesia after the RISS block than after the RIB and for the lower NRS pain scores may be the reproducible dermatomal analgesic coverage of the thorax and upper abdomen by the RISS block. Hence, it can be used as a supplement to patch thoracic epidural analgesia [13]. However, there were no significant differences in the intraoperative dosages of propofol and remifentanil, satisfaction scores, and PONV between the two groups.…”

Section: Discussionmentioning

confidence: 94%

“…As a result, the RISS block anesthetizes the lateral cutaneous branches of the thoracic intercostal nerves and can be used in multiple clinical settings for chest wall and upper abdominal analgesia [15]. Longo et al [13] reported the use of the RISS block in non-intubated patients undergoing VATS. They used 15 ml of 0.375% ropivacaine injection in T5-6 and 15 ml of 0.375% ropivacaine injection in T8-9, and at the 1-h and 4-h postoperative evaluation, the patients remained comfortable and pain-free without the need for additional pain medications.…”

Section: Discussionmentioning

confidence: 99%

“…Thereafter, the ultrasound probe was moved caudally and laterally to identify the tissue plane between the serratus anterior and external intercostal muscles for the sub-serratus block at the T8-9 level. The needle was advanced from its previous position, and an additional 20 mL of 0.375% ropivacaine was injected [12,13]. All block procedures were performed by the same anesthesiologist who had administered the RIB and RISS blocks in more than 30 cases before this study.…”

Section: Application Of Block Interventionmentioning

confidence: 99%

“…Recently, some studies have shown that the rhomboid intercostal block (RIB) and the RIB combined with the sub-serratus plane block (RISS) can provide good analgesia effects after VATS [11][12][13][14]. The ultrasound-guided RIB and RISS blocks are two novel analgesic techniques recently described by Elsharkawy et al [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial

et al. 2021

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Background Rhomboid intercostal block (RIB) and Rhomboid intercostal block with sub-serratus plane block (RISS) are the two types of plane blocks used for postoperative analgesia after video-assisted thoracoscopic surgery (VATS). This prospective randomized controlled trial was performed to analyze the postoperative analgesic effects of ultrasound-guided RIB block and RISS block after video-assisted thoracoscopic surgery. Methods Ninety patients aged between 18 and 80 years, with American Society of Anesthesiologists physical status Classes I–II and scheduled for elective unilateral VATS were randomly allocated into three groups. In group C, no block intervention was performed. Patients in group RIB received ultrasound-guided RIB with 20-mL 0.375% ropivacaine and those in group RISS received ultrasound-guided RIB and serratus plane block using a total of 40-mL 0.375% ropivacaine. All patients received intravenous sufentanil patient-controlled analgesia upon arrival in the recovery room. Postoperative sufentanil consumption and pain scores were compared among the groups. Results The dosages of sufentanil consumption at 24 h after the surgery in the RIB and RISS groups were significantly lower than that in group C (p < 0.001 and p < 0.001 for all comparisons, respectively), the postoperative Numerical Rating Scale (NRS) scores in the RIB and RISS groups at 0.5, 1, 3, 6, 12, 18, and 24 h after surgery when patients were at rest or active were significantly lower than that in group C (p < 0.05 for all comparisons). The required dosage of sufentanil and time to first postoperative analgesic request in groupRISS were less than those in the group RIB at 24 h after the surgery (p < 0.001 and p < 0.001 for all comparisons, respectively). Similarly, the Numerical Rating Scale scores for group RISS at 12, 18, and 24 h after the surgery when the patients were active were significantly lower than those for group RIB (p < 0.05 for all comparisons). Conclusion Both ultrasound-guided RIB block and RISS block can effectively reduce the demand for sufentanil within 24 h after VATS, and less sufentanil dosage is needed in patient with RISS block. Ultrasound-guided RIB block and RISS block can effectively relieve pain within 24 h after VATS, and RISS block is more effective.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Application Of Block Interventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial

et al. 2021

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Ultrasound‐guided peripheral trunk block technique: A new approach gradually stepping onto the stage of clinical anesthesia

Liu

Zhu

2021

Ibrain

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In recent years, with the continuous development and validation of new visualization, the ultrasound‐guided peripheral trunk block becomes more mature and has a more extensive and broader implementation scope in clinical anesthesia. Based on this, we reviewed and summarized the literature on peripheral trunk nerve block include: paraspinal block, retrolaminar block, plane block of erect spinal muscle, transverse convex to pleural midpoint block, block of the trapezius muscle and anterior serratus muscle, anterior serratus muscle block, thoracic nerve block, abdominal transverse fascia block, type‐I block of quadratus lumborum, type‐II block of quadratus lumborum, type‐III block of quadratus lumborum, block of the sheath of rectus abdominis. This paper reviews the ultrasound‐guided peripheral trunk block technique, including development history, anatomic basis, implementation methods, advantages and disadvantages of nerve block technique, and describes the bottleneck and difficulties of nerve block technique at present.

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Rhomboid intercostal block or thoracic paravertebral block for postoperative recovery quality after video-assisted thoracic surgery

Wang

Jia

et al. 2023

European Journal of Anaesthesiology

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BACKGROUNDThe analgesic characteristics of rhomboid intercostal block (RIB) remain unclear. Before it can be fully recommended, we compared the recovery quality and analgesic effects of RIB and thoracic paravertebral block (TPVB) for video-assisted thoracoscopic surgery (VATS).OBJECTIVEThe current study aimed to investigate whether there is a difference in postoperative recovery quality between TPVB and RIB.DESIGNA prospective, non-inferiority, randomised controlled trial.SETTINGAffiliated Hospital of Jiaxing University in China from March 2021 to August 2022.PATIENTSEighty patients aged 18 to 80 years, with ASA physical status I to III, and scheduled for elective VATS were enrolled in the trial.INTERVENTIONUltrasound-guided TPVB or RIB was performed with 20 ml 0.375% ropivacaine.MAIN OUTCOME MEASURESThe primary outcome of the study was the mean difference of quality of recovery-40 scores 24 h postoperatively. The non-inferiority margin was defined as 6.3. Numeric rating scores (NRS) for pain at 0.5, 1, 3, 6, 12, 24 and 48 h postoperatively in all patients were also recorded.RESULTSA total of 75 participants completed the study. The mean difference of quality of recovery-40 scores 24 h postoperatively was −1.6 (95% CI, −4.5 to 1.3), demonstrating the non-inferiority of RIB to TPVB. There was no significant difference between the two groups in the area under the curve for pain NRS over time, at rest and on movement, at 6, 12, 24 and 48 h postoperatively (all P > 0.05), except for the area under the curve pain NRS over time on movement at 48 h postoperatively (P = 0.046). There were no statistical differences between the two groups in the postoperative sufentanil use at 0 to 24 h or 24 to 48 h (all P > 0.05).CONCLUSIONOur study suggests that RIB was non-inferior to TPVB for the quality of recovery, with almost the same postoperative analgesic effect as TPVB after VATS.CLINICAL TRIAL REGISTRATIONchictr.org.cn: ChiCTR2100043841.

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Rhomboid intercostal and subserratus plane block for non-intubated video-assisted thoracoscopic surgery

Cited by 5 publications

References 3 publications

Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial

Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial

Ultrasound‐guided peripheral trunk block technique: A new approach gradually stepping onto the stage of clinical anesthesia

Rhomboid intercostal block or thoracic paravertebral block for postoperative recovery quality after video-assisted thoracic surgery

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