Analgesic Efficacy of Combined Serratus Anterior Plane Block in Acute Pain After Video-Assisted Thoracoscopic Surgery.

Autor: Zengin, Emine Nilgün
Předmět:
Zdroj: Journal of Anesthesia / Anestezi Dergisi (JARSS); 2023 Special Issue, Vol. 31, p263-263, 1p
Abstrakt: Background: With video-assisted thoracoscopic surgery (VATS), procedures such as lobectomy, bullectomy, and wedge resection are performed successfully. Although VATS causes less pain than thoracotomy, pain control should be done carefully. Ultrasound-guided serratus anterior plane block (SAPB) is a new method characterized by long block time, wide block range, and low risk of serious procedure-related complications. Local anesthetic solution for SAPB can be given under, over, or both below and above the serratus anterior muscle. Multisite injection of local anesthetic for SAPB may provide more effective analgesia, with a spread in different areas in patients undergoing VATS Case: The files of 4 patients who underwent VATS and combined SAPB (CSAPB) for postoperative analgesia were reviewed retrospectively for the study. All patients had written informed consent. Deep SAPB (15 mL 0.25% bupivacaine) and superficial SAPB (15 mL 0.25% bupivacaine) were applied to the patients with ultrasound-guided single-needle insertion. Demographic data of the patients, postoperative procedurerelated side effects (pneumothorax, hematoma, bleeding, allergy, nausea, vomiting, etc.), postoperative pain levels (visual analog scale: VAS), and additional analgesia used were recorded. The mean age of the patients was 69 years. While 3 patients were female, 1 patient was male. The mean body mass index of the patients was 30.7. All patients were ASA 3. The mean surgical time was 225 minutes. Wedge resection was performed in 3 patients due to nodules, while lobectomy was performed in one patient due to cancer. The mean VAS scores of the patients at the postoperative 1st hour, 2nd hour, 4th hour, 12th hour, and 24th hour were recorded as 1.75, 1.75, 1.5, 1, 1, respectively. The mean arterial pressures, heart rates and peripheral oxygen saturations of the patients were within the normal range. None of the procedure-related side effects were observed in the patients. No patient used additional analgesics. Conclusion: CSAPB application was found to provide sufficient analgesic efficacy in acute pain after VATS. Because it is very superficial, CSAPB can be easily seen and applied by ultrasound. It can be applied safely due to its distance from the pleura. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index