Association of Serratus Anterior Plane Block for Minimally Invasive Direct Coronary Artery Bypass Surgery With Higher Opioid Consumption: A Retrospective Observational Study

Moll, Vanessa; Maffeo, Carla L.; Mitchell, Matthew; Ward, Ceressa T.; Groff, Robert F.; Lee, Simon J. Craddock; Halkos, Michael E.; Jabaley, Craig S.; O’Reilly-Shah, Vikas N

doi:10.1053/j.jvca.2018.04.043

Cited by 25 publications

(31 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

“…We identified three RCTs involving 238 patients and five retrospective cohort studies involving 375 patients that investigated the serratus anterior plane block for thoracotomy surgery. Serratus anterior plane block was compared with: multi‐level intercostal nerve blocks in two studies ; thoracic paravertebral blockade in two studies ; systemic analgesia alone in three studies ; thoracic epidural analgesia in one study ; and continuous wound infiltration in one study . Three of these studies had more than two treatment arms: Saad et al.…”

Section: Resultsmentioning

confidence: 99%

“…compared serratus anterior plane block vs. thoracic paravertebral blockade vs. systemic analgesia ; Moll et al. compared single‐injection serratus anterior plane block vs. continuous serratus anterior plane block vs. single‐injection thoracic paravertebral blockade vs. systemic analgesia alone ; and Kaushal et al. compared serratus anterior plane block vs. PECS 2 block vs. intercostal nerve blocks .…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

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

et al. 2020

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2020

View full text Add to dashboard Cite

show abstract

The Role of Ultrasound in the Management of Cardiac Patients

Kaye

Koress

Hall

et al. 2021

Ultrasound Fundamentals

View full text Add to dashboard Cite

Fascial Plane Blocks as Regional Analgesia Techniques for Cardiac Surgeries: a Technical Description and Evidence Update

Nooli,

Goldhammer,

Linganna

et al. 2023

Curr Anesthesiol Rep

View full text Add to dashboard Cite

Purpose of Review This article aims to review the anatomy and ultrasound techniques of common interfascial plane blocks used for cardiac surgeries along with the current available evidence for regional analgesia. Recent Findings Thoracic erector spinae plane block (ESPB) has a beneficial role in studies when compared with intravenous pain medications or control groups without blocks for cardiac surgeries. Some retrospective studies showed variable analgesic benefits with ESPB, and a recent meta-analysis did not show promising benefits over thoracic epidural analgesia. Serratus anterior plane block (SAPB) is beneficial with minithoractomy incisions for minimally invasive cardiac surgeries, while para sternal blocks (PSB) or parasternal intercostal plane (PIP) blocks are useful for sternotomy incisions. Pectolaris nerve blocks (PECS) have also been used for various cardiac surgeries with a promising role in cardiac pacemaker and ICD surgeries. Summary There is an increasing trend in the usage of fascial plane blocks for cardiac surgeries. Most can be used as components of multimodal analgesia and play a key role in enhanced recovery after cardiac surgery (ERACS) programs. The choice of these fascial plane blocks as opioid-sparing regional analgesia techniques depends on the incision and type of cardiac surgery. A combination of various fascial plane blocks can be used to increase the efficacy of these blocks, but caution should be exercised in limiting the total quantity of the local anesthetic administered.

show abstract

Association of Serratus Anterior Plane Block for Minimally Invasive Direct Coronary Artery Bypass Surgery With Higher Opioid Consumption: A Retrospective Observational Study

Cited by 25 publications

References 24 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

The Role of Ultrasound in the Management of Cardiac Patients

Fascial Plane Blocks as Regional Analgesia Techniques for Cardiac Surgeries: a Technical Description and Evidence Update

Contact Info

Product

Resources

About