Key result
Combined serratus anterior plane block significantly reduced 24-hour morphine consumption (18.27 mg vs 30.30 mg) and postoperative VAS scores over 48 hours compared to deep block after VATS.
Why the study?
Ultrasound-guided plane blocks are frequently employed in VATS, but the effect of deep versus combined serratus anterior plane block needed evaluation.
Does combined serratus anterior plane block improve postoperative analgesia compared to deep serratus anterior plane block in patients undergoing video-assisted thoracoscopic surgery?
RCT (n=60)
Single-blind
Computer-generated random numbers
No
Does combined serratus anterior plane block improve postoperative analgesia compared to deep serratus anterior plane block in patients undergoing video-assisted thoracoscopic surgery?
Absolute Event Rate: 3% vs 3%
p-value: p=<0.001
Combined serratus anterior plane block provides superior postoperative analgesia and reduces morphine consumption compared to deep serratus anterior plane block after video-assisted thoracoscopic surgery.
Supports preferring CSAPB over DSAPB to minimize opioids after VATS; extends comparative block data in thoracic surgery.
Aim: Ultrasound-guided plane blocks have been employed frequently in Video-assisted thoracoscopic surgery (VATS). The aim of this study was to evaluate the effect of deep and combined serratus anterior plane block (SAPB) after VATS.Material and Method: The patients, in the age range of 18 to 65 years, with the American Society of Anesthesiologists (ASA) physical status of I-III, and body mass index (BMI) of 18-30 kg/m2, and undergoing lung resection with VATS were included in the study. Patients were informed about the study, and their written consent was obtained. Patients were divided into Deep SAPB (DSAPB) (Group 1) and combined SAPB (CSAPB) (Group 2) groups according to the analgesia protocol.Results: There was no statistically significant difference between the groups in terms of demographic characteristics and surgical features (p>0.05). When the groups were evaluated in terms of the block performance time, it was found to be statistically significantly longer in the CSAPB group than in the DSAPB group (p<0.001). When the groups were evaluated in terms of VAS resting scores, the 1st, 2nd, 4th, 8th, 16th, 24th, and 48th-hour VAS resting results were found to be statistically significantly higher in the DSAPB group than the CSAPB group (p<0.05). VAS cough scores were statistically significantly higher in the DSAPB group at the 1st, 2nd, 4th, 8th, 16th, 24th, and 48th-hour (p<0.05). When the groups were evaluated in terms of the side effects, additional analgesic use, and morphine consumption, they were found to be statistically significantly higher in the DSAPB group than in the CSAPB group (p: 0.026, p: 0.020, p<0.001, respectively).Conclusion: CSAPB provided effective analgesia after VATS for 48 hours. In addition, morphine consumption and the need for additional analgesics were low in CSAPB. However, the duration of the block procedure was longer in the CSAPB application.
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Zengіn et al. (2023) conducted an RCT in Lung resection with video-assisted thoracoscopic surgery (VATS) (n=60). Combined serratus anterior plane block (CSAPB) vs. Deep serratus anterior plane block (DSAPB) was evaluated on VAS resting score at 1st hour (p=<0.001). Combined serratus anterior plane block significantly reduced 24-hour morphine consumption (18.27 mg vs 30.30 mg) and postoperative VAS scores over 48 hours compared to deep block after VATS.
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