scholarly journals Dexmedetomidine as an adjuvant to bupivacaine in ultrasound-guided serratus anterior plane block in patients undergoing video-assisted thoracoscopic surgeries

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mohammed Abdelsalam Menshawi ◽  
Hany Magdy Fahim
Keyword(s):  
Study Groups ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Hemodynamic Stability ◽  
Video Assisted ◽  
Significant Difference ◽  
Sedation Scores ◽  
Vas Scores ◽  
Group B ◽  
Anterior Plane

Abstract Background The purpose of this study was the assessment of the analgesic and hemodynamic implications of dexmedetomidine used as an additive to bupivacaine in ultrasound-guided serratus anterior plane (SAP) block for patients undergoing video-assisted thoracoscopic surgeries (VATS ) under general anesthesia. Results The hemodynamic stability was maintained perioperatively with no significant difference of MBP and HR recordings between the two study groups (P > 0.05). The time to 1st postoperative analgesic demand was significantly longer in group BD than in group B (P < 0.05). The postoperative total nalbuphine and rescue ketorolac requirements were significantly lower in group BD than in group B (P < 0.05). The VAS scores were significantly lower in group BD at 8th and 12th h postoperatively than in group B, with no significant difference at 0–6 h and 18–24 h postoperatively (P > 0.05). Ramsay sedation scores were significantly higher in the group BD than in group B in the initial 1st h after surgery (P < 0.05) with no significant difference at the subsequent postoperative recordings (P > 0.05). Conclusion Using dexmedetomidine (0.5 μg/kg) as an additive to bupivacaine for SAP block prolongs the duration of postoperative analgesia and reduces the postoperative analgesic requirements in the 1st 24 h after VATS without any significant side effects.

Ultrasound-guided Serratus Anterior Plane Block Versus Thoracic Paravertebral Block on Alleviating the Acute and Chronic Pain Following the Video-assisted Thoracic Surgery: a Prospective, Randomized, Double-blinded Non-inferiority Clinical Trial

2021 ◽  
Author(s):  
Yan Wang ◽  
Jing Hao ◽  
Simin Huang ◽  
Xiaoping Gu ◽  
Zhengliang Ma
Keyword(s):  
Clinical Trial ◽  
Chronic Pain ◽  
Thoracic Surgery ◽  
Ultrasound Guided ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Vas Scores ◽  
Secondary Outcomes ◽  
Double Blinded ◽  
Anterior Plane

Abstract Background: The anesthetic efficacy of ultrasound-guided serrate anterior plane block (SAPB) on alleviating postoperative acute and chronic pain has been well concerned. The present study aims to compare the efficacy between ultrasound-guided SAPB and thoracic paravertebral block (PVB) on alleviating both acute pain and chronic pain following the video-assisted thoracic surgery. Methods: It was a prospective, randomized, double-blinded non-inferiority clinical trial involving 99 patients with lung nodules receiving video-assisted thoracic surgery with ultrasound-guided SAPB (SAPB group) or PVB (PVB group) on T4 and T7 vertebra using 0.375% ropivacaine at 2 mg/kg. The Visual Analogue Scale (VAS) scores at both rest and cough at 24 h postoperatively were graded as the primary outcome. Besides, secondary outcomes included the incidence of chronic pain at 3 and 6 months postoperatively, VAS scores at rest and cough at 1, 6, 12 and 48 h postoperatively, consumptions of fentanyl and remifentanyl, and the pressing times of the patient-controlled analgesia (PCA) pump. Baseline characteristics, surgery characteristics and primary and secondary outcomes between groups were compared. Results: A total of 92 eligible patients were recruited, including 46 in SAPB group and 46 in PVB group. Baseline and surgery characteristics between groups were comparable (all P>0.05). No significant differences in VAS scores at rest and cough at 1 h, 6 h, 12 h, 24 h, 48 h, 3 months and 6 months postoperatively between SAPB group and PVB group were detected (all P>0.05). Conclusion: The anesthetic efficacy of ultrasound-guided SAPB was not inferior to PVB on alleviating postoperative acute and chronic pain following the video-assisted thoracic surgery.Trial registration number: retrospective registered in the Chinese Clinical Trial Registry (ChiCTR2100050991, http://www.chictr.org.cn, 09/09/2021, Yan Wang, MD).

scholarly journals A Randomized Trial to Compare Serratus Anterior Plane Block and Erector Spinae Plane Block for Pain Management Following Thoracoscopic Surgery

Pain Medicine ◽  
2020 ◽  
Vol 21 (6) ◽  
pp. 1248-1254
Author(s):  
Mürsel Ekinci ◽  
Bahadir Ciftci ◽  
Birzat Emre Gölboyu ◽  
Yavuz Demiraran ◽  
Yusuf Bayrak ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Thoracoscopic Surgery ◽  
Opioid Consumption ◽  
Erector Spinae ◽  
Serratus Anterior ◽  
Erector Spinae Plane Block ◽  
Significant Difference ◽  
Vas Scores ◽  
Anterior Plane ◽  
Effective Analgesia

Abstract Objective Comparison of ultrasound (US)-guided erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) in video-assisted thoracic surgery (VATS) patients. The primary outcome was to compare perioperative and postoperative (48 hours) opioid consumption. Methods A total of 60 patients were randomized into two groups (N = 30): an ESPB group and an SAPB group. All the patients received intravenous patient-controlled postoperative analgesia and ibuprofen 400 mg intravenously every eight hours. Visual analog scale (VAS) scores, opioid consumption, and adverse events were recorded. Results Intraoperative and postoperative opioid consumption at 0–8, 8–16, and 16–24 hours and rescue analgesic use were significantly lower in the ESPB group (P &lt; 0.05). Static/dynamic VAS scores were significantly lower in the ESPB group (P &lt; 0.05). There was no significant difference between static VAS scores at the fourth hour. There were no differences between adverse effects. Block procedure time and one-time puncture success were similar between groups (P  &gt; 0.05 each). Conclusion US-guided ESPB may provide better pain control than SAPB after VATS. Question Even though there are studies about analgesia management after VATS, clinicians want to perform the technique that is both less invasive and more effective. Findings This randomized trial showed that US-guided ESPB provides effective analgesia compared with SAPB. Meaning Performing single-injection ESPB reduces VAS scores and opioid consumption compared with SAPB.

Ultrasound-guided parasternal Pecs block: a new and useful supplement to Pecs I and serratus anterior plane blocks

2016 ◽  
Author(s):  
Dr Christian Kruse Hansen ◽  
◽  
Dr Mette Dam ◽  
Dr Troels Dirch Poulsen ◽  
Dr Per-Arne Lönnqvist ◽  
...  
Keyword(s):  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Anterior Plane

scholarly journals The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽  
2021 ◽  
pp. 1-9
Author(s):  
Serdar Sahin ◽  
Havva Sezer ◽  
Ebru Cicek ◽  
Yeliz Yagız Ozogul ◽  
Murat Yildirim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Health Care Providers ◽  
Study Groups ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Care Providers ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D

<b><i>Introduction:</i></b> The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. <b><i>Methods:</i></b> We included the patients &#x3e;18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight &#x3c;25 kg/m<sup>2</sup> (Group A), overweight from 25 to &#x3c;30 kg/m<sup>2</sup> (Group B), Class I obesity 30 to &#x3c;35 kg/m<sup>2</sup> (Group C), and ≥35 kg/m<sup>2</sup> (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. <b><i>Results:</i></b> There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [<i>p</i> = 0.017], Group D vs. Group A [<i>p</i> = 0.001], and Group D vs. Group C [<i>p</i> = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [<i>p</i> = 0.025], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> = 0.006], and Group D vs. Group C [<i>p</i> = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [<i>p</i> &#x3c; 0.001], Group C vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> &#x3c; 0.001], and Group D vs. Group C [<i>p</i> = 0.010]). <b><i>Conclusion:</i></b> COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

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