Analgesic Effect of Serratus Anterior Plane Block After Thoracoscopic Surgery: A Randomized Controlled Double-Blinded Study

Abstract

Purpose

Fast-track surgery is a developing trend in medical care. It is a core challenge for clinical anesthesia to reasonably reduce the dosage of opioids and relieve postoperative pain. Serratus anterior plane block (SAPB) is a novel analgesic technique with such advantages as easy operation, good safety, and few side effects.

Patients and Methods

In total, 60 patients aged 18 to 65 years who were diagnosed with lung cancer and scheduled for thoracoscopic resection were randomly assigned to receive SABP or local infiltration anesthesia. We analyzed the time within 48 hrs after operation to visual analogue scale (VAS) pain score of 4 or higher and the number of patients requiring additional analgesics at 6 hrs and 12 hrs after operation.

Results

The estimated median time to VAS ≥4 was 4 hrs (1.32 to 6.68) in the control group and 11 hrs (6.71 to 15.29) in the SAPB group (log-rank test: P=0.008). The number of patients requiring additional analgesics at 6- and 12 hrs after operation was significantly lower in the SAPB group than that in the control group (P<0.05).

Conclusion

Compared with local infiltration, SAPB provided extended postoperative analgesia after thoracoscopic surgery with reduced consumption of additional analgesics in the early postoperative stage.

Keywords:

• fast-track surgery
• video-assisted thoracic surgery
• serratus anterior plane block
• analgesia
• clinical anesthesia
• randomized clinical trial

Abbreviations

ASA, American Society of Anesthesiologists; BIS, bispectral index; BMI, body mass index; BP, blood pressure; ECG, electrocardiogram; IQR, interquartile range; NSAIDs, non-steroidal anti-inflammatory drugs; PACU, post-anesthesia care unit; PetCO2, end-tidal carbon dioxide partial pressure; PTi, pain threshold index; SAPB, serratus anterior plane block; SD, standard deviation; SpO2, oxygen saturation; TEB, thoracic epidural block; VAS, visual analogue scale; VATS, video-assisted thoracoscopic surgery.

Data Sharing Statement

We intend to share individual deidentified patient data which is included in the manuscript. No further specific data or study documents will be shared. The data shared will be accessible on the website (http://www.chictr.org.cn/addproject2.aspx) within 6 months after the study is received.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from every patient included in the study.

Acknowledgments

We would like to acknowledge and express our deepest gratitude to the participants of this study.

Author Contributions

All authors made a significant contribution to the work reported, whether in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all of these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest for this work.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. There is no funding to report.