TY - JOUR
T1 - Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery
AU - Semyonov, Michael
AU - Fedorina, Ekaterina
AU - Grinshpun, Julia
AU - Dubilet, Michael
AU - Refaely, Yael
AU - Ruderman, Leonid
AU - Koyfman, Leonid
AU - Friger, Michael
AU - Zlotnik, Alexander
AU - Klein, Moti
AU - Brotfain, Evgeni
N1 - Funding Information:
The authors declare that the all patients gave written informed consent, and that this study was conducted in accordance with the Declaration of Helsinki. The study was approved by the Soroka University Medical Center Human Research and Ethics Committee (RN-0345 – 16.SOR).
Publisher Copyright:
© 2019 Semyonov et al.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: 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. Methods: 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. Results: 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 (P<0.001). The total dosage of morphine and tramadol required for pain relief during the first hours after surgery was significantly lower in the patients who received SAP block. Also, the incidence of vomiting after surgery was significantly lower among the patients who received SAP block than among the patients who received standard pain control. Conclusion: The results of the present study suggest that SAP block is an effective adjuvant treatment option for post-thoracic surgery analgesia. Compared to the current methods used for post-thoracic surgery pain relief, SAP block has some significant merits, particularly its ease of use and its low potential for side effects.
AB - Background: 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. Methods: 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. Results: 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 (P<0.001). The total dosage of morphine and tramadol required for pain relief during the first hours after surgery was significantly lower in the patients who received SAP block. Also, the incidence of vomiting after surgery was significantly lower among the patients who received SAP block than among the patients who received standard pain control. Conclusion: The results of the present study suggest that SAP block is an effective adjuvant treatment option for post-thoracic surgery analgesia. Compared to the current methods used for post-thoracic surgery pain relief, SAP block has some significant merits, particularly its ease of use and its low potential for side effects.
KW - Post-thoracic surgery pain relief
KW - Post-thoracotomy analgesia
KW - Serratus anterior plane block
KW - Thoracic surgery
KW - Thoracoscopy
KW - Ultrasound-guided regional anesthesia
UR - http://www.scopus.com/inward/record.url?scp=85065904346&partnerID=8YFLogxK
U2 - 10.2147/JPR.S191263
DO - 10.2147/JPR.S191263
M3 - Article
AN - SCOPUS:85065904346
VL - 12
SP - 953
EP - 960
JO - Journal of Pain Research
JF - Journal of Pain Research
SN - 1178-7090
ER -