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Effects of serratus anterior plane block for postoperative analgesia after thoracoscopic surgery compared with local anesthetic infiltration: a randomized clinical trial

Authors Chen G, Li Y, Zhang Y, Fang X

Received 28 February 2019

Accepted for publication 2 July 2019

Published 1 August 2019 Volume 2019:12 Pages 2411—2417


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Michael A Überall

Video abstract presented by Guodong Chen.

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Guodong Chen,1,2 Yufang Li,1,2 Yixiao Zhang,1,2 Xiangming Fang1

1Department of Anesthesiology and Intensive Care, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, People’s Republic of China; 2Department of Anesthesiology, Zhejiang Province Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou 310003, People’s Republic of China

Background: Serratus anterior plane (SAP) block is a relatively novel technique that can block the lateral cutaneous branches of the intercostal nerves as well as the long thoracic nerve.
Purpose: Our study aimed to evaluate the effects of SAP block on postoperative pain after thoracoscopic surgery compared with local anesthetic (LA) infiltration.
Patients and methods: Forty adult patients undergoing video-assisted thoracic surgery were randomized to receive either SAP block (n=20) or LA infiltration of incision (n=20). The primary outcome was postoperative visual analog scale (VAS) score at the 2nd, 8th, 16th, 24th, and 48th hour after surgery. The secondary outcomes were the consumption of sufentanil at 8th, 16th, 24th hours postoperative. In addition, rescue analgesia, drug-related adverse effects after surgery was also analyzed.
Results: The SAP group showed lower VAS scores at the 2nd hour (at rest: SAP group 11 [8–13] vs LA group 28 [26–32], P=0.01; on coughing: 15 [13–18] vs 33 [26–38], P=0.01) and the 8th hour (at rest: 13 [12–18] vs 36 [32–46], P=0.01; on coughing: 19 [16–23] vs 42 [36–53], P=0.01) after surgery. Postoperative sufentanil consumption in the SAP group during 0–8 hrs was significantly lower compared with the LA group (P<0.01). The use of rescue analgesia was also significantly lower in the SAP group (P=0.02) during 0–12 hrs.
Conclusion: Compared to LA infiltration, ultrasound-guided SAP block may provide better pain relief as well as reduce opioid consumption after thoracoscopic surgery.

Keywords: serratus anterior plane block, thoracoscopic surgery, local anesthetic infiltration

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