Serratus-intercostal interfascial plane block: alternative analgesia for open nephrectomy?

Martín, M.T. Fernández; Álvarez, S. López; Pérez, Mario Fajardo; Herrero, María Pérez

doi:10.23736/s0375-9393.18.12808-2

Cited by 13 publications

(7 citation statements)

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“…The hyperalgesia of dermatomal block levels T4-T11 can be examined in the lateral region of the abdomen at 30 min. Previous studies 17,[21][22][23][24] have shown that SAPB is more frequently used in thoracic anesthesia, and relatively few studies have reported its application in hepatectomy. Elsharkaw et al 25 reported a case series of the application of rhomboid intercostal and sub-serratus plane blocks for postoperative pain management in upper abdominal surgery, which could better block the lateral cutaneous branches of the thoracic intercostal nerves and be used for thoracic and upper abdominal analgesia in various clinical situations.…”

Section: Discussionmentioning

confidence: 99%

“…5 Ultrasound-guided serratus anterior plane block (SAPB) provides accurate ultrasound localization for block catheter placement and has been gradually applied for pain management after upper abdominal surgery as a new fascial plane block technique in recent years. [12][13][14] It was first described by Blanco in 2013 and has a high block success rate in contrast to thoracic epidural analgesia and paravertebral block. Ultrasound-guided SAPB not only reduces surgical stress response, inflammatory factor release, and opioid use 15 but also avoids hemodynamic fluctuations and serious respiratory and intraspinal sequelae.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Ultrasound-Guided Continuous Low Serratus Anterior Plane Block for Pain Management After Hepatectomy: A Randomized Controlled Trial

Jiang¹,

Wu²,

Liu³

et al. 2023

JPR

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Adequate postoperative analgesia is a key to earlier recovery from open surgery. This work investigated the pain control and quality of patient recovery after hepatectomy to evaluate the modified continuous serratus anterior plane block (called low SAPB) for postoperative analgesia. Patients and Methods: This single-center, blinded, randomized, controlled study included 136 patients who underwent hepatectomy under general anesthesia. For postoperative analgesia, the patients in the SAPB group were given a continuous low SAPB at the 7th intercostal space in the right mid-axillary line, and the patients in the control group were given continuous intravenous opioid analgesia. The numeric pain rating scale (NPRS) was used for pain assessment. The postoperative assessment focused on the remedial drug consumption, the occurrence of adverse postoperative analgesic reactions, and the quality of patient recovery evaluated with the QoR-15 questionnaire. Results: Compared to the controls, the SAPB patients had significantly lower NPRS scores at 12 h and 24 h at rest and 6 h, 12 h, and 24 h in motion, and a longer time to first use of remedial analgesics at 24 h, and higher overall QoR-15 scores at 24 h [124 (121, 126) vs 121 (120, 124)] and 48 h [129 (126, 147) vs 126 (125, 128)], after surgery. There was no significant difference in the incidence of analgesia-related adverse reactions between the two groups. Conclusion:The continuous low SAPB could achieve superior pain control, especially for motor pain, to intravenous opioid analgesia during the first 24 h post-surgery. Even with no significant difference in the incidence of postoperative adverse reactions, patients with continuous low SAPB appeared to have a higher quality of recovery in the first two days post-surgery than patients with continuous intravenous analgesia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of Ultrasound-Guided Continuous Low Serratus Anterior Plane Block for Pain Management After Hepatectomy: A Randomized Controlled Trial

Jiang¹,

Wu²,

Liu³

et al. 2023

JPR

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“…The block was effective for somatic analgesia after gastrectomy and cholecystectomy in a small series of cases. 21,22 Afterwards, more than one study reported the effectiveness of SIPB for open upper abdominal surgeries. 5,8,23 SIPB lacks an analgesic effect on visceral pain, yet control of the somatic component of postoperative pain can result in satisfactory pain scores and minimize the required rescue analgesics.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have used the SIPB bolus technique for analgesia after unilateral abdominal surgeries. 5,8,21,22,24 Compared with the oblique subcostal TAB block; SIPB compared with the rectus sheath block significantly improved the quality of analgesia and lowered the analgesic requirement in patients undergoing laparoscopic cholecystectomy. 5 Interestingly, bilateral SIPB was effectively used as a rescue analgesia after bariatric surgery, achieving an adequate NRS pain score after 10 min and lasting for 46 hours.…”

Section: Discussionmentioning

confidence: 99%

“…5 The suggested advantages of SIPB include the ease of the technique, the solid landmarks, and the possible administration in the supine position. 6 In this study, continuous SIPB; using catheter technique was investigated as an adequate analgesic option for patients undergoing elective open abdominal surgeries. The primary objective of the study was to control postoperative pain assessed by the numerical rating scale (NRS) on the first postoperative day.…”

Section: Main Pointsmentioning

confidence: 99%

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Continuous Serratus - Intercostal Plane Block for Perioperative Analgesia in Upper Abdominal Surgeries: A Prospective Randomized Controlled Study

Mamoun,

Alrefaey,

Abo-Zeid

2023

TJAR

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Objective: Acute pain management after open abdominal surgeries is an essential goal in perioperative management.. Recently, serratusintercostal plane block (SIPB) was suggested as an analgesic technique for upper abdominal surgeries.Methods: This prospective, randomized, controlled study included sixty adult patients scheduled for open upper abdominal surgeries. Patients were allocated into two equal groups: SIPB group (S group, n = 30) and control group (the C group, n = 30). In the S group, SIPB was performed in the midaxillary line at the eighth rib level followed by continuous infusion of local anaesthetic for the first postoperative day. In the C group, no block was done. The primary objective of the study was to control postoperative pain on the first postoperative day as assessed by the numerical rating scale (NRS). Secondary outcomes included perioperative hemodynamics, total postoperative analgesic consumption, number of analgesic requests, and incidence of postoperative nausea and vomiting. Results:The mean postoperative NRS reported in group S was statistically lower than that in group C (2.4±0.7, 3.9±0.31, P < 0.001). The postoperative morphine consumption was lower in the S group than in the C group [(0 (0-4), 3 (1-4), respectively, P < 0.001]. The incidence of PONV was significantly lower in the S group than in the C group (16.7% and 40%, P < 0.045). Conclusion:SIPB was associated with a better analgesic profile compared with the control group after upper abdominal surgeries. Further studies are recommended to determine block safety in special patient groups, including bariatric and laparoscopic surgeries.

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Adición de bloqueo serrato-intercostal/BRILMA para cirugía de acceso arteriovenoso: 2 casos clínicos

Sanllorente-Sebastián

Rodríguez-Joris

Avello-Taboada

et al. 2020

Revista Española de Anestesiología y Reanimación

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Serratus-intercostal interfascial plane block: alternative analgesia for open nephrectomy?

Cited by 13 publications

References 0 publications

Assessment of Ultrasound-Guided Continuous Low Serratus Anterior Plane Block for Pain Management After Hepatectomy: A Randomized Controlled Trial

Assessment of Ultrasound-Guided Continuous Low Serratus Anterior Plane Block for Pain Management After Hepatectomy: A Randomized Controlled Trial

Continuous Serratus - Intercostal Plane Block for Perioperative Analgesia in Upper Abdominal Surgeries: A Prospective Randomized Controlled Study

Adición de bloqueo serrato-intercostal/BRILMA para cirugía de acceso arteriovenoso: 2 casos clínicos

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