Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery

• Published in: Journal of pain research 2019-01, Vol.12, p.953-960
• Main Authors: Semyonov, Michael, Fedorina, Ekaterina, Grinshpun, Julia, Dubilet, Michael, Refaely, Yael, Ruderman, Leonid, Koyfman, Leonid, Friger, Michael, Zlotnik, Alexander, Klein, Moti, Brotfain, Evgeni
• Format: Article
• Language: English
• Subjects: Original Research; Serratus Anterior Plane Block; Thoracic Surgery; thoracoscopy
• ISSN: 1178-7090; 1178-7090
• DOI: 10.2147/JPR.S191263

Patients who undergo surgical procedures that impair the integrity of the chest wall frequently experience extremely severe postoperative pain. Opiates and weaker analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are not sufficiently effective in achieving control of severe pain and might cause respiratory and gastrointestinal complications. In the past decade, there has been an increased interest in the use of regional nerve blocks for post-thoracoscopy and post-thoracotomy analgesia. This is a prospective, randomized, double-blind and single-center study. We recruited 104 patients who underwent elective thoracoscopy. Prior to surgery, the participating patients were randomized into one of two study groups: Group 1- the "standard control group" that received standard postoperative pain control with intravenous opioids, NSAIDs and acetaminophen (paracetamol) and Group 2- the "block group" that was treated by ultrasound-guided serratus anterior plane (SAP) block (a single injection of 0.25% bupivacaine hydrochloride 2 mg/kg plus dexamethasone 8 mg) with standard postoperative pain control regimen. We compared the clinical, laboratory, and postoperative pain assessment data of both groups. Patients in the SAP block Group 2 reported significantly lower levels of pain after thoracic surgery as assessed by their visual analog scale scores, as compared to the patients in the standard pain control Group 1 (