The Safety and Efficacy of Ultrasound-Guided Serratus Anterior Plane Block (SAPB) Combined with Dexmedetomidine for Patients Undergoing Video-Assisted Thoracic Surgery (VATS): A Randomized Controlled Trial

Figures & data

Table 1 Demographic and Clinical Characteristics

	Group D1 (n=35)	Group D2 (n=36)	P-values
Age (years)	53.41±5.34	52.18±3.94	0.272
Sex (female/male, n)	16/19	14/22	0.561
BMI (kg·m^–2)	23.56±2.03	22.69±1.78	0.059
ASA I to II (n)	17/18	19/17	0.723
FEV1/FVC (%)	87.83±2.80	89.45±3.62	0.083
Left/Right (n)	26/9	25/11	0.650
Comorbidity, n (%)  Hypertension  Diabetes mellitus  Coronary heart disease	10 (28.57%) 6 (17.14%) 4 (11.43%)	9 (25.00%) 6 (16.67%) 5 (13.89%)	1.000
Type of surgery, n (%)  Lobectomy  Segmentectomy  Wedge resection	22 (62.86%) 8 (22.86%) 5 (14.29%)	26 (72.22%) 6 (16.67%) 4 (11.11%)	0.715

Notes: Variables presented as mean ± SD or number of patients n (%).

Abbreviations: BMI, body mass index; ASA, American Society of Anesthesiology; FEV1/FVC, forced vital capacity rate of one second/forced vital capacity.

Figure 1 Patient enrollment flow diagram.

Table 2 Intraoperative Variables Between the Two Groups

	Group D1 (n=35)	Group D2 (n=36)	P-values
Duration of surgery (min)	118.45±23.83	125.74±33.22	0.293
Duration of anaesthesia (min)	165.29±32.44	168.33±35.02	0.706
Intraoperative bleeding (mL)	120.23±31.03	111.83±29.28	0.245
Fluids (mL)	1829.53±158.73	1725.81±129.88	0.056
Urine output (mL)	637.92±63.42	629.63±73.09	0.612
Dexmedetomidine (μg·kg^–1·h^–1)	0.38±0.33	0.25±0.24*	0.043
Remifentanil (μg·kg^–1·min^–1)	0.15±0.04	0.11±0.06**	0.002
Sevoflurane (%)	1.99±0.55	1.70±0.65*	0.047
Cisatracurium dosage (mg·kg^–1)	0.22±0.06	0.23±0.05	0.448
Dermatomal analgesia span, n (%)  4 dermatomes  5 dermatomes  6 dermatomes  7 dermatomes	5 (14.29%) 10 (28.57%) 12 (34.29%) 8 (22.86%)	5 (13.89%) 9 (25.00%) 13 (36.11%) 9 (25.00%)	1.000
Recovery time (min)	18.34±5.31	14.53±3.45**	0.001
Riker Sedation-Agitation Scale	4.43±0.43	4.31±0.21	0.138
Number of using vasoactive agent n (%)	12 (34.29%)	18 (50.00%)	0.180

Notes: Variables presented as mean ± SD or number of patients n (%). *P < 0.05 vs Group D1; **P < 0.01 vs Group D1.

Figure 2 Comparison of the intraoperative hemodynamic changes between the two groups. *P<0.05 vs the D1 group.

Figure 3 Comparison of postoperative pain intensity (at rest and with coughing) between the two groups. *P<0.05 vs the D1 group.

Figure 4 Comparison of postoperative sufentanil consumption between the two groups. *P<0.05 vs the D1 group.

Table 3 Postoperative Variables Between the Two Groups

	Group D1 (n=35)	Group D2 (n=36)	P-values
Patients required rescue analgesia, n (%)	14 (40.00%)	6 (16.67%)*	0.029
Time to first dose of rescue analgesia (h)	4.26 (2.73–7.83)	6.34 (3.56–9.27)*	0.025
Total dose of rescue analgesia (µg)	35.76±6.07	21.66±3.47**	0.001
Patient satisfaction score	4.00 (3.00–5.00)	4.25 (3.25–5.00)	0.065
Surgeon satisfaction score	4.50 (4.00–5.00)	4.75 (4.25–5.00)	0.085
Chest tube removed (d)	2.13±0.56	1.91±0.62	0.122
Length of hospital (d)	6.73±1.47	6.98±1.62	0.499
Quality of Life Scale	72.34±14.92	65.24±18.24	0.077
Activity of daily living score	14.55±4.83	16.23±4.77	0.145
The prevalence of chronic pain	10 (28.57%)	8 (22.22%)	0.539

Notes: Variables presented as mean±SD, number of patients n (%) or median (interquartile range). *P <0.05 vs Group D1, **P <0.01 vs Group D1.

Table 4 Postoperative Adverse Effects in the Two Groups

	Group D1 (n=35)	Group D2 (n=36)	P-values
Nausea	12 (34.29%)	5 (13.89%)*	0.044
Urinary retention	8 (22.86%)	5 (13.89%)	0.329
Itching	4 (11.43%)	3 (8.33%)	0.710
Hypotension	2 (5.71%)	5 (13.89%)	0.429
Pneumonia	7 (20.00%)	2 (5.56%)*	0.085
Cardiovascular events	0	0	1.000
SAPB related complications	0	0	1.000

Notes: Variables presented as number of patients n (%). *P < 0.05 vs Group D1.