Comparison of intraoperative and post-operative effects of serratus anterior plane block performed with ultrasound and infiltration block in patients undergoing video-assisted thoracoscopic surgery
Mustafa Dikici1
, Selcan Akesen2, Belgin Yavaşcaoğlu2, Ahmet Sami Bayram3, Fatma Nur Kaya2, Alp Gurbet2
1Department of Anesthesiology and Reanimation, Bursa City Hospital, Bursa
2Department of Anesthesiology and Reanimation, Bursa Uludağ University Faculty of Medicine, Bursa
3Department of Thorax Surgery, Bursa Uludağ University Faculty of Medicine, Bursa, Turkey
Keywords: Infiltration block, post-operative analgesia, serratus anterior plan block, video-assisted thoracoscopic surgery.
Abstract
Objectives: We aimed to compare the intraoperative and post-operative analgesic activities of the preventive applied serratus anterior
plane (SAP) block and infiltration block in patients undergoing video-assisted thoracoscopic surgery (VATS).
Methods: The study was carried out in 60 patients aged between 18 and 80 who were eligible for elective VATS, with the American
Society of Anesthesiologists classification I-II, following ethical committee approval and written informed consent form. Patients were
divided into two groups as SAP (group serratus anterior plane block [SAPB]) and group infiltration block after routine monitoring and
general anesthesia induction by recording demographic data after randomization. Hemodynamic data of all patients were recorded
before, after induction and within intraoperative 30 min period. Patient controlled analgesia (PCA) prepared with morphine was applied
to all patients postoperatively. Intraoperative hemodynamic data and opioid consumption of patients, resting time, and coughing
visual analog scale, time to first PCA dose, post-operative opioid consumption, rescue analgesic requirement, mobilization times,
opioid side effects, and patient and surgical team’s satisfaction were evaluated.
Results: Intraoperative hemodynamic data and opioid consumption were similar between the two groups. Post-operative pain scores
(0 and 30 min, 1, 2, 4, 8, and 12 h) were lower in the SAPB group (p<0.005) and time to use the first PCA (p=0.002) was longer in the
SAPB group. Post-operative PCA and rescue analgesic requirement were lower in the SAPB group (p=0.002, p=0.00). It was found
that the first mobilization time was shorter in the SAPB group (p=0.003), and opioid-related side effects were similar in both groups
(p=0.067). Patient and surgical team satisfaction was high in the SAPB group (p=0.004, p=0.000).
Conclusion: As a result, more effective post-operative analgesia was provided with preventively SAPB, compared to infiltration block
in patients undergoing VATS.