Serratus anterior plane block and erector spinae plane block in postoperative analgesia in thoracotomy: A randomised controlled study

Abstract

Background and Aims: Managing pain after thoracic surgery is crucial and the traditional methods have many adverse effects. We aimed to evaluate serratus anterior plane block (SAPB) and erector spinae plane block (ESPB) in acute pain control in thoracic cancer surgeries. Methods: This randomised controlled, triple-blind study was performed on 90 patients, between 18 and 70 years old, scheduled for elective thoracic cancer surgery. Patients were allocated into three equal groups: Control group: received sham ESPB and sham SAPB. SAPB group received SAPB (20 ml bupivacaine 0.5%) and sham ESPB. ESBP group received ESPB (20 ml bupivacaine 0.5%) and sham SAPB. Results: Postoperative morphine consumption was significantly lower in ESBP and SAPB groups than control group [ESPB (8.52 ± 4.29 mg) < SAPB (19.57 ± 7.63 mg) < control (36.37 ± 8.27 mg)] ( P < 0.001). Numerical rating scale pain score was comparable among the groups at rest, but was significantly lower at 30 min, 2, 4 h in ESPB and SAPB groups, than control group on coughing. The scores were better in SAPB compared to control group till 4 h. At 8, 12, 24 h, the difference between control and SAPB groups became insignificant, but it remained the least in ESPB group. Postoperative forced vital capacity and forced expiratory volume in the first second after 24 h were the best in ESPB group and better in SAPB group compared to the control group. Conclusion: Both ESPB and SAPB reduced intraoperative and postoperative opioid consumptions and postoperative dynamic pain scores with improved postoperative pulmonary functions in thoracic surgery with the ESPB being superior.

A Comparative Study of Analgesic Effect of Ultrasound Guided Erector Spinae Plane Block Versus Serratus Anterior Plane Block for Thoracoscopic Sympathectomy Surgeries

“…In accordance, Hassan and Wadod (14) , have illustrated Both the ESBP and SAPB groups consumed considerably less postoperative morphine than the control group [ESPB (8.52 ±4.29 mg) SAPB (19.57 ±7.63 mg) control (36.37 ±8.27 mg)] (p <0.001).…”

“…Hassan and Wadod (14) have demonstrated that Scale of numerical ratings At rest, the pain levels were comparable between the groups, but after 30 minutes, two hours, and four hours of coughing, the pain scores in the ESPB and SAPB groups were considerably lower than those in the control group. At 8, 12, and 24 hours, there was no longer much of a difference between the control and SAPB groups, but the ESPB group still had the smallest difference.…”

Comparing ultrasound-guided serratus anterior plane block with erector spinae plane block for postoperative analgesia in thoracic and breast surgery: A systematic review and meta-analysis

“…Among the included articles, ve studies were judged as having a low risk of bias [23][24][25][26]27]. Two studies were judged as having an unclear risk of bias [29,30], and four studies were judged as having a high risk of bias [28, [31][32][33].…”

“…Ten studies reported opioid consumption 24 h postoperatively in patients undergoing thoracic or breast surgery with ESPB and SAPB [23][24][25][26][27][28][29][30][31][32]. Meta-analysis revealed that ESPB signi cantly reduced 24-hour opioid consumption compared with SAPB (SMD: -0.76; 95% CI: -1.29 to -0.24; P < 0.01; I 2 = 88%) (Fig.…”

“…Six studies reported intraoperative opioid consumption after the use of ESPB and SAPB in patients receiving thoracic or breast surgery [23,25,27,[30][31][32]. Meta-analysis revealed that compared with the SAPB group, patients in the ESPB group had signi cantly reduced intraoperative opioid consumption (SMD:…”