The serratus anterior plane block for analgesia after thoracic surgery: A meta-analysis of randomized controlled trails

Xiancun Liu, Tingting Song, Hai-Yang Xu, Xuejiao Chen, Pengfei Yin, Jingjing Zhang, Xiancun Liu, Tingting Song, Hai-Yang Xu, Xuejiao Chen, Pengfei Yin, Jingjing Zhang

Abstract

Background: The serratus anterior plane (SAP) block is a newer method that can be used in patients undergoing thoracic surgeries. The postoperative analgesia efficacy of SAP blocks for thoracic surgery remains controversial. We conduct a meta-analysis to evaluate the analgesia of SAP blocks after thoracic surgery.

Methods: We searched PubMed, Embase, EBSCO, the Cochrane Library, Web of Science, and CNKI for randomized controlled trials (RCTs) regarding the postoperative pain control of a SAP block on thoracic surgery. All of the dates were screened and evaluated by two researchers and meta-analysis was performed using RevMan5.3 software.

Results: A total of 8 RCTs involving 542 patients were included. The meta-analysis showed statistically significant differences between the two groups with respect to postoperative pain scores at 2 h (standardized mean difference [Std.MD] = -1.26; 95% confidence interval [CI] = -1.66 to -0.86; P < .0001); 6 h (SMD = -0.50; 95%CI = -0.88 to -0.11; P = .01); 12 h (SMD = -0.63; 95%CI = -1.10 to -0.16; P = .009); 24 h (SMD = -0.99; 95%CI = -1.44 to -0.51; P < .0001); postoperative opioid consumption at 24 h (SMD = -0.83; 95%CI = -1.10 to -0.56; P < .00001); and postoperative nausea and vomiting (PONV) rates (RR = 0.39; 95% CI = 0.21-0.73; P = .003).

Conclusion: The SAP block can play an important role in the management of pain after thoracic surgery by reducing both pain scores and 24-h postoperative opioids consumption. In addition, there is fewer incidence of PONV in the SAP block group.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Risk of bias assessment of summary.
Figure 3
Figure 3
Risk of bias assessment of the studies.
Figure 4
Figure 4
Forest plot for the meta-analysis of postoperative pain scores at 2 h.
Figure 5
Figure 5
Forest plot for the meta-analysis of postoperative pain scores at 6 h.
Figure 6
Figure 6
Forest plot for the meta-analysis of postoperative pain scores at 12 h.
Figure 7
Figure 7
Forest plot for the meta-analysis of postoperative pain scores at 24 h.
Figure 8
Figure 8
Forest plot for the meta-analysis of postoperative opioids consumption at 24 h.
Figure 9
Figure 9
Forest plot for the meta-analysis of PONV.

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Source: PubMed

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