Ultrasound-Guided Serratus Anterior Plane Block for Pain Management Following Minimally Invasive Repair of Pectus Excavatum

Altun, Gülbin Töre; Arslantaş, Mustafa Kemal; Dinçer, Pelin Çorman; Aykaç, Zeynep Zuhal

doi:10.1053/j.jvca.2019.03.063

Cited by 18 publications

(14 citation statements)

References 28 publications

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“…There were 42 non‐randomised studies: 13 comparative cohort studies ; 19 case series ; and 10 case reports . Six of the cohort studies ; 14 of the case series ; and seven of the case reports were available only as abstracts or posters from conference proceedings.…”

Section: Resultsmentioning

confidence: 99%

“…Six of the cohort studies ; 14 of the case series ; and seven of the case reports were available only as abstracts or posters from conference proceedings. Twenty‐nine non‐randomised studies described the use of serratus anterior plane block in thoracic trauma and in surgical procedures including lung resection and minimally invasive cardiac surgery: nine comparative cohort studies ; 13 case series ; and eight case reports . Fourteen non‐randomised studies evaluated PECS blocks in a wide range of cardiothoracic applications, including: thoracotomy; sternotomy; transcatheter cardiac procedures; cardiac device placement; and thoracic trauma.…”

Section: Resultsmentioning

confidence: 99%

“…). The seven cohort studies published in the peer‐reviewed literature had a median (IQR [range]) score of 7 (7–7 ) on the 9‐point Newcastle‐Ottawa Scale, whereas the six cohort studies published as abstracts or posters had a median (IQR [range]) score of 6 (5.25–6 ) (see also Supporting Information, Table S2).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies described serratus anterior plane block and PECS blocks for thoracic analgesia for indications other than those already outlined above (level 4 evidence; see also Supporting Information, Table S6). In a retrospective cohort study of 95 patients of age 8–39 years undergoing minimally invasive pectus excavatum repair (Nuss procedure), bilateral pre‐incisional single‐injection superficial serratus anterior plane blocks resulted in significantly lower opioid requirements in the first 24 h compared with no block, with a median (IQR) patient‐controlled demands of 23 (14–48) vs. 61 (31–136), respectively, and 15 (10–22) vs. 25 (15–42) doses delivered, respectively (ranges not reported) . Median (IQR) pain scores were similarly low in both groups (0 (0–1) at all time‐points; ranges not reported).…”

Section: Resultsmentioning

confidence: 99%

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The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review

et al. 2020

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Summary Serratus anterior plane and pectoral nerves blocks are recently described alternatives to established regional anaesthesia techniques in cardiac surgery, thoracic surgery and trauma. We performed a systematic review to establish the current state of evidence for the analgesic role of these fascial plane blocks in these clinical settings. We identified relevant studies by searching multiple databases and trial registries from inception to June 2019. Study heterogeneity prevented meta‐analysis and studies were instead qualitatively summarised and stratified by type of surgery and comparator. We identified 51 studies: nine randomised control trials; 13 cohort studies; 19 case series; and 10 case reports. The majority of randomised controlled trials studied the serratus anterior plane block in thoracotomy or video‐assisted thoracoscopic surgery, with only two investigating pectoral nerves blocks. The evidence in thoracic trauma comprised only case series and reports. Results indicate that single‐injection serratus anterior plane and the pectoral nerves blocks reduce pain scores and opioid consumption compared with systemic analgesia alone in cardiothoracic surgery, cardiac‐related interventional procedures and chest trauma for approximately 6–12 h. The duration of action appears longer than intercostal nerve blocks but may be shorter than thoracic paravertebral blockade. Block duration may be prolonged by a continuous catheter technique with potentially similar results to thoracic epidural analgesia. There were no reported complications and the risk of haemodynamic instability appears to be low. The current evidence, though limited, supports the efficacy and safety of serratus anterior plane and the pectoral nerves blocks as analgesic options in cardiothoracic surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review

et al. 2020

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“…The method was describ 2005 as a parasternal block and is performed without ultrasound guidance. This tech Mini-review: The SAP block is often used in combined anesthesia in thorax and cardiac surgery [24,25]. In addition to providing significant hemodynamic stability and reduced opioid consumption, it also has a very good analgesic effect [26,27].…”

Section: Transversus Thoracic Muscle Plane Blockmentioning

confidence: 99%

Use of Ultrasound-Guided Interfascial Plane Blocks in Anterior and Lateral Thoracic Wall Region as Safe Method for Patient Anesthesia and Analgesia: Review of Techniques and Approaches during COVID-19 Pandemic

Szamborski

Janc

Rosińczuk

et al. 2022

IJERPH

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Ultrasound-guided interfascial plane blocks performed on the anterior and lateral thoracic wall have become an important adjuvant method to general anesthesia and an independent method of local anesthesia and pain management. These procedures diminish the harmful effects of anesthesia on respiratory function and reduce the risk of phrenic nerve paralysis or iatrogenic pneumothorax. In postoperative pain management, interfascial plane blocks decrease the dosage of intravenous drugs, including opioids. They can also eliminate the complications associated with general anesthesia when used as the sole method of anesthesia for surgical procedures. The following procedures are classified as interfascial plane blocks of the anterior and lateral thoracic wall: pectoral nerve plane block (PECS), serratus anterior plane block (SAP), transversus thoracic muscle plane block (TTP), pectoral interfascial plane block (PIF), and intercostal nerve block (ICNB). These blocks are widely used in emergency medicine, oncologic surgery, general surgery, thoracic surgery, cardiac surgery, orthopedics, cardiology, nephrology, oncology, palliative medicine, and pain medicine. Regional blocks are effective for analgesic treatment, both as an anesthesia procedure for surgery on the anterior and lateral thoracic wall and as an analgesic therapy after trauma or other conditions that induce pain in this area. In the era of the COVID-19 pandemic, ultrasound-guided interfascial plane blocks are safe alternatives for anesthesia in patients with symptoms of respiratory distress related to SARS-CoV-2 and appear to reduce the risk of COVID-19 infection among medical personnel.

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Chest Wall Nerve Blocks for Cardiothoracic, Breast Surgery, and Rib-Related Pain

Sharma

Louie

Thai

et al. 2022

Curr Pain Headache Rep

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Ultrasound-Guided Serratus Anterior Plane Block for Pain Management Following Minimally Invasive Repair of Pectus Excavatum

Cited by 18 publications

References 28 publications

The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review

The role of serratus anterior plane and pectoral nerves blocks in cardiac surgery, thoracic surgery and trauma: a qualitative systematic review

Use of Ultrasound-Guided Interfascial Plane Blocks in Anterior and Lateral Thoracic Wall Region as Safe Method for Patient Anesthesia and Analgesia: Review of Techniques and Approaches during COVID-19 Pandemic

Chest Wall Nerve Blocks for Cardiothoracic, Breast Surgery, and Rib-Related Pain

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