Serratus Anterior Plane Block for Post-Thoracotomy Analgesia: a Novel Technique for the Surgeon and Anaesthetist

Vig, Saurabh; Bhan, Surya; Ahuja, Deepti; Gupta, Nishkarsh; Kumar, Vinod; Kumar, Sunil; Bharati, Sachidanad Jee

doi:10.1007/s13193-019-00937-2

Cited by 9 publications

(9 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hanley et al (16) compared the effects of continuous SAPB and continuous TPVB on postoperative analgesia after VATS surgery, and the results showed that continuous SAPB, as part of the MMA program, did not have an inferior analgesic effect within 48h after surgery, which confirmed the effectiveness of continuous SAPB in postoperative analgesia. However, Vig et al (17) conducted continuous SAPB for 10 patients undergoing lateral thoracotomy, and 4 patients still needed additional pump injection for analgesia after surgery. Therefore, the authors believed that continuous SAPB had significant individual differences in alleviating postoperative pain after lateral thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

A randomized clinical trial: optimal strategies of paravertebral nerve block combined with general anesthesia for postoperative analgesia in patients undergoing lobectomy: a comparison of the effects of different approaches for serratus anterior plane block

Er¹,

Xia²,

Gao³

et al. 2021

Ann Palliat Med

View full text Add to dashboard Cite

Background: To observe the analgesic effect of different ultrasound-guided methods of serratus anterior plane block (SAPB) after surgery in patients who have undergone thoracoscopic lobectomy with general anesthesia combined with thoracic paravertebral nerve block.Methods: A total of 120 patients aged 18-65 years old scheduled for video-assisted thoracoscopic surgery (VATS) were selected. Patients were randomly divided into 3 groups: patient-controlled intravenous analgesia (PCIA) group, serratus anterior plane block (SPB) group and continuous serratus anterior plane block (CSPB) group (n=40 each). All patients were treated with general anesthesia combined with doublepoint (T4, T7) thoracic paravertebral block. The SPB group received an ultrasound-guided single serratus plane block. The CSPB group underwent the same procedure as the SPB group, with an epidural catheter inserted. Both the PCIA and SPB groups received PCIA after surgery. Patients in the CSPB group were connected to a continuous serratus block automatic analgesia pump after surgery.Results: There were no significant differences among the 3 groups in terms of the general condition.Compared with the PCIA group, the resting and exercise VAS pain scores at T2, T3, T4, and T5 , cortisol level at T1, T4 and T5 in SPB group and CSPB group were lower (P<0.05), the times of the first analgesia were significantly prolonged, and the times of pressing the PCA pump and opioid use were significantly less in the SPB and CSPB groups, and the CSPB group used no opioids (P<0.05), the SPB group and CSPB group had shorter times of the first postoperative activity, longer mobilization distance and the total number of days in hospital was significantly lower (P<0.05). Postoperative complications in the SPB and CSPB groups were significantly less and the CSPB group had an even lower incidence of postoperative complications (P<0.05).Compared with the SPB group, active VAS pain scores at T4 and T5 were higher in the CSPB group (P<0.05).Compared with the PCIA group, the total QoR-40 score at T6 was significantly higher in the SPB and CSPB groups, and compared with the SPB group, this data was higher in the CSPB group (P<0.05).Conclusions: Single ultrasound-guided SAPB combined with PCIA can provide a better analgesic effect, improve the quality of early postoperative recovery, and accelerate ERAS.

show abstract

Section: Discussionmentioning

confidence: 99%

A randomized clinical trial: optimal strategies of paravertebral nerve block combined with general anesthesia for postoperative analgesia in patients undergoing lobectomy: a comparison of the effects of different approaches for serratus anterior plane block

Er¹,

Xia²,

Gao³

et al. 2021

Ann Palliat Med

View full text Add to dashboard Cite

show abstract

“…Compared with a single-shot block, a continuous ropivacaine infusion may increase the risk of catheter-related infections and delay early postoperative activity, especially for patients with cachexia (involving low muscle mass) who need a subcutaneous tunneling approach to maintain the placement of the catheter. 9 As a result, we only added the two doses of DEX during the SAPB. Although there is lack of direct evidence of α 2 -adrenoceptors on the axons of normal peripheral nerves, the opioid-sparing mechanisms of DEX are thought to include centrally mediated analgesia, action on peripheral nerve α 2 B-adrenoceptors, and attenuation of the inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

“…It can provide analgesia from T2 to T9 by blocking the intercostal nerves and their lateral cutaneous branches. 8,9 However, the duration of analgesia can only last for 6-8 h. 10,11 The use of local anesthetics along with dexmedetomidine (DEX) has been reported to prolong analgesia in epidural, paravertebral and brachial plexus blocks. [12][13][14] However, it remains unclear whether ropivacaine combined with DEX during ultrasound-guided SAPB could improve postoperative analgesia.…”

Section: Introductionmentioning

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

View full text Add to dashboard Cite

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.

show abstract

“…I read the recently published case series in Indian Journal of Surgical Oncology on "Serratus Anterior Plane Block for Post-Thoracotomy Analgesia: A Novel Technique for the Surgeon and Anaesthetist" by Vig et al with interest [1]. I would like to congratulate and thank the authors for sharing their research work.…”

mentioning

confidence: 98%

Regional Analgesia Technique for Post-Thoracotomy Pain

Mistry

2020

Indian J Surg Oncol

View full text Add to dashboard Cite

Serratus Anterior Plane Block for Post-Thoracotomy Analgesia: a Novel Technique for the Surgeon and Anaesthetist

Cited by 9 publications

References 10 publications

A randomized clinical trial: optimal strategies of paravertebral nerve block combined with general anesthesia for postoperative analgesia in patients undergoing lobectomy: a comparison of the effects of different approaches for serratus anterior plane block

A randomized clinical trial: optimal strategies of paravertebral nerve block combined with general anesthesia for postoperative analgesia in patients undergoing lobectomy: a comparison of the effects of different approaches for serratus anterior plane block

<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>

Regional Analgesia Technique for Post-Thoracotomy Pain

Contact Info

Product

Resources

About