Ultrasound-Guided Double-Point Versus Single-Point Serratus Anterior Plane Block for Modified Radical Mastectomy: A Randomized Controlled Trial.

Autor:	Xu J; Departments of Anesthesiology.; Oncology, Shanghai Medical College, Fudan University, Shanghai, China., Ling D; Departments of Anesthesiology.; Outcomes Research Consortium,Houston, TX., Xu Q; Departments of Anesthesiology., Sun P; Departments of Anesthesiology., Wei S; Outcomes Research Consortium,Houston, TX.; Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China., Gao L; Departments of Anesthesiology., Lou F; Departments of Anesthesiology., Zhang J; Departments of Anesthesiology.; Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Jazyk:	angličtina
Zdroj:	The Clinical journal of pain [Clin J Pain] 2025 Jan 01; Vol. 41 (1). Date of Electronic Publication: 2025 Jan 01.
DOI:	10.1097/AJP.0000000000001256
Abstrakt:	Objectives: The double-point serratus anterior plane block (SAPB) covers more area, including the axilla, than the single-point approach, potentially offering better pain relief after modified radical mastectomy (MRM). The objective of this study were to evaluate the clinical outcomes of these 2 procedures for patients treated with MRMs. Methods: Sixty women were randomly assigned to double- or single-point groups. Double-point received SAPB at the third and fifth ribs, single-point at the fifth rib. The primary outcome includes pain numeric rating scale (NRS) at rest and movement 24 hours postsurgery. The secondary outcomes are axilla comfort NRS, recovery quality, and adverse events. Results: At 24 hours postsurgery, the double-point group compared with the single-point group showed movement pain NRS of 3 (2 to 3) versus 3 (3 to 4) ( P =0.011) and rest pain NRS of 1 (1 to 1) versus 2 (1 to 3) ( P =0.037). The difference between them did not exceed the minimum clindically important difference (MCID). The axillary comfort NRS in the double-point group was lower than the single-point group at 6 and 12 hours postsurgery, at 1 (1 to 2) versus 2 (2 to 4) ( P =0.001) and 1 (1 to 2) versus 2 (2 to 4) ( P =0.01), respectively, but there were no statistically significant differences at 24 and 48 hours postsurgery. At 48 hours postsurgery, pain scores and opioid use were similar in both groups. Recovery scores, rescue analgesia timing, adverse events, and hospital stay length were similar in both groups. Discussion: Double-point SAPB offers wider anesthetic spread but shows no significant clinical advantage in pain or axillary comfort over single-point SAPB after MRM. Competing Interests: This study was supported by the Medical Guidance Supporting Project of the Shanghai Municipal Science and Technology Committee (No. 22Y11904200). The authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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