Efficacy of postsurgical ultrasound guided serratus intercostal plane block and wound infiltration on postoperative analgesia after female breast surgeries. A comparative study

Abstract

ObjectiveThe serratus intercostal plane block is successfully performed for pain management after breast surgeries. To assess the efficacy and safety of serratus intercostals plane block in comparison with local wound infiltration in women under-going breast surgery.MethodsThis prospective study was conducted on 46 female patients undergoing breast surgeries.Patients were divided into two groups: serratus block (SB) group (n = 23): patients received induction with serratus intercostal plane block with 0.4 ml/kg bupivacaine 0.25% plus fentanyl 20 μg, infiltration group (n = 23) received induction with the borders of the surgical wound were infiltrated with 0.4 ml/kg of bupivacaine 0.25% and 20 μg fentanyl at the end of surgery.VAS pain scores, postoperative patient satisfaction score, time to the first analgesic requirement, total dose of rescue analgesic and the incidence of postoperative complications as vomiting were all recorded.ResultsIntraoperative pain scores and postoperative patient satisfaction scores were significantly lower in group SB compared with infiltration group. Total dose of rescue analgesic was significantly lower in SB group compared with Infiltration group. Significant difference between the study groups regarding the incidence of vomiting. Time to the first analgesic dose was significantly longer in group SB compared to Infiltration group.ConclusionThere is considerable evidence that serratus intercostal plane block in addition to general anesthesia provide better postoperative pain control with little adverse effects compared with wound infiltration, indicating that a perioperative serratus intercostal plane block is a feasible and effective method for an improved postoperative pain treatment after breast surgery.