Efficacy of ultrasound-guided serratus anterior plane block for postoperative analgesia in patients undergoing thorascopic surgery

Abstract

Objective To evaluate the efficacy of ultrasound-guided serratus anterior plane block (SAPB) for postoperative analgesia in patients undergoing thoracoscopic surgery. Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18-24 kg/m2, scheduled for elective thoracoscopic surgery under general anesthesia, were divided into 3 groups (n=20 each) using a random number table method: control group (group C), thoracic paravertebral block(PVB)group (group PVB) and group SAPB.After the patients were turned to contralateral position, thoracic PVB was performed at T4, 6 thoracic vertebrae on the affected side under ultrasound guidance, and 0.25% ropivacaine 20 ml was injected in group PVB.In group SAPB, ultrasound-guided SAPB was performed on the affected side, and 0.33% ropivacaine 30 ml was injected.Patient-controlled intravenous analgesia (PCIA) was performed at the end of surgery.PCIA pump was pressed when numerical rating scale scores>3 after surgery and flurbiprofen axetil 2 mg/kg was intravenously injected when the efficacy was inadequate.The requirement for PCIA pressing, total consumption of drugs during PCIA and requirement for flurbiprofen axetil were recorded at day 3 after surgery.The consumption of sufentanil during operation was recorded, the dose was calculated, and the total amount of sufentanil consumed was recorded.The development of postoperative nausea and vomiting, pulmonary infection and chronic pain was also recorded. Results Compared with group C, the consumption, dose and total consumption of sufentanil were significantly decreased, the number of pressing times of PCIA and total consumption of drugs during PCIA were decreased, and the incidence of postoperative nausea and vomiting was decreased in PVB and SAPB groups (P 0.05). There was no significant difference in the incidence of chronic pain among the three groups (P>0.05), and no patients required additional flurbiprofen axetil. Conclusion Ultrasound-guided SAPB provides good efficacy for postoperative analgesia in the patients undergoing thoracoscopic surgery with fewer adverse effects. Key words: Nerve block; Ultrasonography; Analgesia, postoperative; Thoracoscopy