Observation of the analgesic effect of superficial or deep anterior serratus plane block on patients undergoing thoracoscopic lobectomy

Lan Qiu, Xiaoxuan Bu, Jiang Shen, Min Li, Linyi Yang, Qingrong Xu, Yongjun Chen, Jianping Yang, Lan Qiu, Xiaoxuan Bu, Jiang Shen, Min Li, Linyi Yang, Qingrong Xu, Yongjun Chen, Jianping Yang

Abstract

The effectiveness of anterior serratus plane block in postoperative analgesia of thoracic surgery is beginning to emerge. Currently, there are 2 methods of anterior serratus plane block: deep serratus plane block (DSPB) and superficial serratus plane block (SSPB). In clinical practice, there is no an unified view regarding the advantages and disadvantages between 2 methods. This study aimed to observe and compare the analgesic effects of 2 methods on patients undergoing thoracoscopic lobectomy, in order to provide some suggestions for anesthesiologists when they choose anterior serratus plane block to perform postoperative analgesia for patients.

Patients were randomly divided into 3 groups (21 patients/group):

  1. 1.

    general anesthesia group (P group);

  2. 2.

    combined general anesthesia and SSPB group (S group), and

  3. 3.

    combined general anesthesia and DSPB group (D group).

The patients in groups S and D received 0.4 ml/kg of 0.375% ropivacaine for ultrasound-guided block after surgery. Postoperatively, flurbiprofen was used for rescue analgesia.

Visual analog scale (VAS) pain scores were recorded at 6 hours, 12 hours, and 24 hours after surgery, and rescue analgesia, post-operative nausea, and vomiting were reported within 24 hours after surgery. At 6 hours, 12 hours, and 24 hours, the VAS scores and the rescue analgesia rates in groups S and D were significantly lower than those in group P (all P < .001). With prolonging time, the VAS in group D was significantly increased by 0.11 per hour as compared with that of group P (P < .0001); VAS in group D was significantly increased by 0.12 per hour as compared with that of group S (P < .0001).

Ultrasound-guided anterior serratus plane block can provide adequate analgesia for patients undergoing thoracoscopy lobectomy. SSPB can significantly improve VAS scores as compared to DSPB at 24 hours.

Conflict of interest statement

The authors have no conflicts of interests to disclose.

Figures

Figure 1
Figure 1
SSPB was performed by an in-plane technique using nerve block needle (a); DSPB was performed by an in-plane technique using nerve block needle (b). ld = latissimus dorsi, r5 = rib5, sa = serratus anterior.
Figure 2
Figure 2
CONSORT chart outlining patient selection in the trial. DSPB = deep anterior serratus plane block, GA = general anesthesia, SSPB = superficial anterior serratus plane block.
Figure 3
Figure 3
VAS score curves of 3 anesthesia methods over time (6 hours, 12 hours, and 24 hours). VAS = visual analog scale.

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