Serratus anterior plane block for minimally invasive valve surgery thoracotomy pain

Kazior, Michael R.; King, Adam; Lopez, Marcos G.; Billings, Frederic T.; Costello, William T.

doi:10.1016/j.jclinane.2019.01.019

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…Due to complex factors, such as blood coagulation, anticoagulation, and hemodynamic instability, pain following thoracotomy is often difficult to handle in patients with cardiac surgery. Kazior et al (22) conducted an observational cohort study and selected 20 patients who underwent minimal invasive thoracotomy. Patients who underwent valvular thoracotomy were randomly divided into two groups.…”

Section: Thoracotomymentioning

confidence: 99%

A narrative review of ultrasound-guided serratus anterior plane block

Xie¹,

Guo²,

Chen³

et al. 2021

Ann Palliat Med

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third to sixth intercostal nerves, the long thoracic and thoracodorsal nerves. It has been used in breast surgeries, rib fractures, and thoracotomy to manage pain of the anterolateral chest wall. In this review, we briefly describe the anatomy, operation, drug selection, block range, and clinical application of SAPB. We present the following article in accordance with the Narrative Review reporting checklist (available at http://dx.

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Section: Thoracotomymentioning

confidence: 99%

A narrative review of ultrasound-guided serratus anterior plane block

Xie¹,

Guo²,

Chen³

et al. 2021

Ann Palliat Med

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“…There were no significant differences between all interventions regarding postoperative morphine consumption, duration of hospitalization, postoperative complications, total adverse reactions, and PONV. The SAPB provides analgesia by blocking branches of the intercostal nerve without the pleural nerve, which may lead to a poor analgesic effect 41 , 42 .…”

Section: Discussionmentioning

confidence: 99%

Relative efficacy and safety of several regional analgesic techniques following thoracic surgery: a network meta-analysis of randomized controlled trials

Li,

Sun,

Zong

et al. 2023

International Journal of Surgery

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Background: This network meta-analysis (NMA) was performed to assess the relative efficacy and safety of various regional analgesic techniques used in thoracic surgery. Materialsand methods: Randomized controlled trials (RCTs) evaluating different regional analgesic methods were retrieved from databases, including PubMed, Embase, Web of Science, and the Cochrane Library, from inception to March 2021. The surface under the cumulative ranking curve (SUCRA) was estimated to rank the therapies based on the Bayesian theorem. Moreover, sensitivity and subgroup analyses were performed on the primary outcomes to obtain more reliable conclusions. Results: Fifty-four trials (3,360 patients) containing six different methods were included. Thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) were ranked the highest in reducing postoperative pain. As for total adverse reactions and postoperative nausea and vomiting (PONV), postoperative complications, and duration of hospitalization, ESPB was found to be superior to other methods. It should be noted that there were few differences between various methods for all outcomes. Conclusions: Available evidence suggests that ESPB might be the most effective and safest method for relieving pain after thoracic surgery, shortening the length of hospital stay and reducing the incidence of postoperative complications.

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“…This is consistent with previously published studies which have reported decreased VAS scores with thoracic interfascial plane blocks for patients undergoing thoracotomy for cardiac and pulmonary surgical procedures. 25,26,31,32 Berthoud et al evaluated pain outcomes in patients who received SAPB vs continuous wound infiltration with ropivacaine after minimally invasive heart surgery and reported significantly lower VAS scores immediately after the block in the SAPB group. 25 Toscano et al compared pain outcomes in patients undergoing right anterior thoracotomy for valve surgery who received SAPB vs intravenous morphine and reported lower mean VAS scores at 24 hours, but this was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Interfascial Plane Blocks and Outcomes After Minithoracotomy for Valve Surgery

Cheruku

Fox

Heravi

et al. 2022

Semin Cardiothorac Vasc Anesth

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Introduction. Thoracic interfascial plane blocks are increasingly used for pain management after minimally invasive thoracotomy for valve repair and replacement procedures. We hypothesized that the addition of these blocks to the intercostal nerve block injected by the surgeon would further reduce pain scores and opioid utilization. Methods. In this retrospective cohort study, 400 consecutive patients who underwent minimally invasive thoracotomy for mitral or aortic valve replacement and were extubated within 2 hours of surgery were enrolled. The maximum pain score and opioid utilization on the day of surgery and other outcome variables were compared between patients who received interfascial plane blocks and those who did not. Results.193 (48%) received at least one interfascial plane block while 207 (52%) received no interfascial plane block. Patients who received a thoracic interfascial plane block had a maximum VAS score on the day of surgery (mean 7.4 ± 2.5) after the block was administered which was significantly lower than patients in the control group who did not receive the block (mean 7.9 ± 2.2) ( P = .02). Opioid consumption in the interfascial plane block group on the day of surgery was not significantly different from the control group. Conclusion. Compared to intercostal blocks alone, the addition of thoracic interfascial plane blocks was associated with a modest reduction in maximum VAS score on the day of surgery. However, no difference in opioid consumption was noted. Patients who received interfascial plane blocks also had decreased blood transfusion requirements and a shorter hospital length of stay.

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Serratus anterior plane block for minimally invasive valve surgery thoracotomy pain

Cited by 6 publications

References 5 publications

A narrative review of ultrasound-guided serratus anterior plane block

A narrative review of ultrasound-guided serratus anterior plane block

Relative efficacy and safety of several regional analgesic techniques following thoracic surgery: a network meta-analysis of randomized controlled trials

Thoracic Interfascial Plane Blocks and Outcomes After Minithoracotomy for Valve Surgery

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