Serratus Anterior Plane Block and Erector Spinae Plane Block Versus Thoracic Epidural Analgesia for Perioperative Thoracotomy Pain Control: A Randomized Controlled Study.

Autor: Elsabeeny WY; Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt. Electronic address: walaa.Elsabeeny@nci.cu.edu.eg., Ibrahim MA; Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt., Shehab NN; Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt., Mohamed A; Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt., Wadod MA; Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2021 Oct; Vol. 35 (10), pp. 2928-2936. Date of Electronic Publication: 2021 Jan 04.
DOI: 10.1053/j.jvca.2020.12.047
Abstrakt: Objectives: This study was designed to evaluate the safety and efficacy of erector spinae plane block and serratus anterior plane block versus thoracic epidural in perioperative pain control for patients with cancer undergoing lung surgeries.
Design: Single blinded, randomized, controlled trial.
Setting: The study was carried out at the National Cancer Institute in Cairo, Egypt.
Participants: Fifty-one patients with cancer.
Interventions: Patients were allocated randomly into three groups: thoracic epidural analgesia (TEA) group, serratus anterior plane block (SAPB) group, and erector spinae plane block (ESPB) group.
Measurements and Main Results: Outcome measures were 24 hours postoperative visual analog scale (VAS), intraoperative rescue fentanyl consumption, perioperative heart rate, mean blood pressure (mean arterial pressure [MAP]), and total postoperative morphine consumption. VAS scores at rest were significantly lower in the TEA group at the postanesthesia care unit and 24 hours. VAS scores with cough were significantly higher in the SAPB group at eight and 24 hours. The first time to receive morphine was significantly longer in the TEA group. No patients in the TEA group required postoperative morphine, whereas 88.2% and 47.1% required morphine in the SAPB and ESPB groups, respectively, p < 0.001. In the TEA group, intraoperative MAP values were lower than the other two groups, p < 0.05.
Conclusions: Erector spinae plane block can be used as an effective and safe alternative to thoracic epidural analgesia and shows superior analgesic profile to serratus anterior plane block for patients with lung cancer undergoing posterolateral thoracotomy.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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