Serratus Anterior Plane Block for Apical TAVR in an Awake Patient

Berthoud, Vivien; Ellouze, Omar; Bièvre, Thomas; Konstantinou, Maria; Jazayeri, Saëd; Bouchot, Olivier; Girard, Claude; Bouhemad, Bélaïd

doi:10.1053/j.jvca.2017.12.042

Cited by 16 publications

(6 citation statements)

References 12 publications

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“…The use of a TPB has been shown to provide effective analgesia and reduce opioid administration, rates of postoperative AF, and lead to earlier extubation time. Although less studied, the SAP blockade is typically employed at our institution and has been described as an alternative to general anesthesia for TA TAVI (45).…”

Section: Analgesiamentioning

confidence: 99%

Anesthesia for minimally invasive cardiac surgery

White¹,

Patvardhan²,

Falter³

2021

J Thorac Dis

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Due to its potential benefits and increased patient satisfaction minimal invasive cardiac surgery (MICS) is rapidly gaining in popularity. These procedures are not without challenges and require careful planning, pre-operative patient assessment and excellent intraoperative communication. Assessment of patient suitability for MICS by a multi-disciplinary team during pre-operative workup is desirable.MICS requires additional skills that many might not consider to be part of the standard cardiac anesthetic toolkit. Anesthetists involved in MICS need not only be highly skilled in performing transesophageal echocardiography (TEE) but need to be proficient in multimodal analgesia, including locoregional or neuroaxial techniques. MICS procedures tend to cause more postoperative pain than standard median sternotomies do, and patients need analgesic management more in keeping with thoracic operations.Ultrasound guided peripheral regional anesthesia techniques like serratus anterior block can offer an advantage over neuroaxial techniques in patients on anti-platelet therapy or anticoagulation with low molecular weight or unfractionated heparin The article reviews the salient points pertaining to pre-operative assessment and suitability, intraoperative process and postoperative management of minimally invasive cardiac procedures in the operating theatre as well as the catheterization lab. Special emphasis is given to anesthetic management and analgesia techniques.

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Section: Analgesiamentioning

confidence: 99%

Anesthesia for minimally invasive cardiac surgery

White¹,

Patvardhan²,

Falter³

2021

J Thorac Dis

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“…The procedure consists of injecting local anesthetic between the muscle planes of the chest wall to block the lateral cutaneous branches of the intercostal nerves [ 11 ]. SAPB has already shown its efficacy in the management of post-operative pain following breast surgery, thoracoscopy, thoracotomy and multiple rib fractures [ 12 – 16 ]. No data has yet been published on the effectiveness of analgesia by SAPB for MIHS.…”

Section: Introductionmentioning

confidence: 99%

Serratus anterior plane block for minimal invasive heart surgery

Berthoud¹,

Ellouze²,

Nguyen³

et al. 2018

BMC Anesthesiol

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BackgroundMinimal invasive heart surgery (MIHS) presents several benefits, but provides intense and prolonged post-operative pain. Our objective was to compare efficacy of serratus anterior plane block (SAPB) with continuous wound infiltration (CWI) for management of post-operative pain following MIHS.MethodsIt’s retrospective, monocentric study between November 2016 to April 2017. The study was performed at the University hospital of Dijon, Burgundy, France. All patients scheduled for MIHS was included. Data was collected retrospectively. During this period, 20 patients had SAPB and 26 had CWI. SAPB was performed before extubation with a single injection of 0.5 mg/kg of ropivacaïne (5 mg/ml). In the CWI group, catheter was inserted in the subcutaneous space by the surgeon at the end of the procedure. A 10 ml bolus of ropivacaïne (7.5 mg/mL) was followed by a continuous infusion (2 mg/ml) between 7 and 12 ml/h for 48 h. Morphine consumption and visual analog score (VAS) were recorded for 48 h. Length of stay in intensive care unit and hospital was also collected.ResultsMorphine consumption and VAS score were significantly lower in SAPB group (p < 0.01). Length of stay in intensive care and hospital was significantly was decreased in SAPB group.ConclusionSAPB appears effective in reducing postoperative MIHS pain.Electronic supplementary materialThe online version of this article (10.1186/s12871-018-0614-5) contains supplementary material, which is available to authorized users.

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“…An exception to this is the TA TAVR as this relies on a mini-thoracotomy [40]. Paravertebral blocks have been shown to provide effective analgesia for this procedure and at the authors' institution PECS and serratus anterior blockade are routinely utilised to augment general anaesthesia [41].…”

Section: Tavrmentioning

confidence: 99%

Anaesthesia for Minimally Invasive Cardiac Surgery

Aston,

Zeloof,

Falter

2023

JCDD

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Minimally invasive cardiac surgery (MICS) has been used since the 1990s and encompasses a wide range of techniques that lack full sternotomy, including valve and coronary artery graft surgery as well as transcatheter procedures. Due to the potential benefits offered to patients by MICS, these procedures are becoming more common. Unique anaesthetic knowledge and skills are required to overcome the specific challenges presented by MICS, including mastery of transoesophageal echocardiography (TOE) and the provision of thoracic regional analgesia. This review evaluates the relevance of MICS to the anaesthetist and discusses pre-operative assessment, the relevant adjustments to intra-operative conduct that are necessary for these techniques, as well as post-operative care and what is known about outcomes.

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Serratus Anterior Plane Block for Apical TAVR in an Awake Patient

Cited by 16 publications

References 12 publications

Anesthesia for minimally invasive cardiac surgery

Anesthesia for minimally invasive cardiac surgery

Serratus anterior plane block for minimal invasive heart surgery

Anaesthesia for Minimally Invasive Cardiac Surgery

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