scholarly journals The Safety and Efficacy of Ultrasound-Guided Serratus Anterior Plane Block (SAPB) Combined with Dexmedetomidine for Patients Undergoing Video-Assisted Thoracic Surgery (VATS): A Randomized Controlled Trial

2020 ◽  
Vol Volume 13 ◽  
pp. 1785-1795
Author(s):  
Xiang Li ◽  
Yanchao Liu ◽  
Jing Zhao ◽  
Zhixiong Xiang ◽  
Chunguang Ren ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Thoracic Surgery ◽  
Controlled Trial ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Safety And Efficacy ◽  
Video Assisted Thoracic Surgery ◽  
Randomized Controlled ◽  
Video Assisted ◽  
Anterior Plane

scholarly journals Improved Analgesic Effect of Paravertebral Blocks before and after Video-Assisted Thoracic Surgery: A Prospective, Double-Blinded, Randomized Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Lihua Chu ◽  
Xiaolin Zhang ◽  
Yaping Lu ◽  
Guohao Xie ◽  
Shengwen Song ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Thoracic Surgery ◽  
Controlled Trial ◽  
Analgesic Efficacy ◽  
Video Assisted Thoracic Surgery ◽  
Randomized Controlled ◽  
Video Assisted ◽  
Group A ◽  
Group B ◽  
Double Blinded

Despite being less invasive, patients who underwent video-assisted thoracic surgery (VATS) suffered considerable postoperative pain. Paravertebral block (PVB) was proven to provide effective analgesia in patients with VATS; however, there is no difference in pain relief between preoperative PVB and postoperative PVB. This study was aimed to investigate the analgesic efficacy of combination of preoperative and postoperative PVB on the same patient undergoing VATS. In this prospective, double-blinded, randomized controlled trial, 44 patients undergoing VATS were enrolled, and they received patient-controlled intravenous analgesia (PCIA) with sufentanil plus preoperative PVB (Group A, n = 15) or postoperative PVB (Group B, n = 15), or combination of preoperative and postoperative PVB (Group C, n = 14). The primary outcome was sufentanil consumption and PCIA press times in the first 24 hours postoperatively. Also, data of postoperative use of PCIA and visual analogue scale (VAS) were collected. In the first 24 hours postoperatively, median sufentanil consumption in Group C was 0 (0–34.75) μg, which was much less than that in Group A (45.00 (33.00–47.00) μg, p=0.005) and Group B (36 (20.00–50.00) μg, p=0.023). Patients in Group C pressed less times of PCIA (0 (0–0) times) than patients in Group A (2 (1–6) times, p<0.001) and Group B (2 (1–3) times, p=0.009). Kaplan–Meier analysis showed patients with combination of preoperative and postoperative PVB had a higher PCIA-free rate than patients with either technique alone (p=0.003). The VAS among the three groups was comparable postoperatively. The combination of both preoperative and postoperative PVB provides better analgesic efficacy during the early postoperative period and may be an alternative option for pain control after VATS. This trial is registered with ChiCTR1800017102.

scholarly journals A Comparison of the Analgesic Efficacy of Serratus Anterior Plane Block Vs Paravertebral Nerve Block for Video-assisted Thoracic Surgery: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Yi Zhang ◽  
Ze Fu ◽  
Te Fang ◽  
Kexin Wang ◽  
Zimeng Liu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Thoracic Surgery ◽  
Nerve Block ◽  
Controlled Trial ◽  
Serratus Anterior ◽  
Promising Alternative ◽  
Long Thoracic Nerve ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Anterior Plane

Abstract Background: Patients who undergo video-assisted thoracic surgery (VATS) that impair the integrity of the chest wall frequently experience moderate to severe postoperative pain. Serratus anterior plane block (SAPB) is a relatively novel technique that can block the lateral cutaneous branches of the intercostal nerves as well as the long thoracic nerve. Methods: Our study aimed to evaluate the analgesic efficiency of deep serratus plane block (DSPB) and superficial serratus anterior plane block (SSPB) as well as paravertebral nerve block (PVB) in the patients undergoing VATS. A total of 74 patients aged from 20-80 undergoing VATS were randomized to receive either DSPB or SSPB as well as PVB. Ultrasound (US) guided DSPB or SSPB as well as PVB with 20ml 0.5% ropivacaine was performed preoperatively to the patients according to their groups. All patients were provided with patient-controlled intravenous analgesia (PCIA) for postoperative analgesia. The primary outcomes were the levels of postoperative pain at rest and on coughing evaluated by visual analog scale (VAS), intraoperative and postoperative opioids consumption. The secondary outcomes included PCIA pressed times, side effects and satisfaction of analgesia, duration of nerve block, intraoperative hemodynamic changes and vasoactive drug dosage. Results: No significant differences of VAS score were found in the three groups at each time points. During operation, PVB reduced consumption of opioids (27.23±5.10mg) compared to DSPB (31.20±3.80mg) and SSPB (32.61±5.28mg) (p<0.05). The effective pressed times of PCIA in SSPB group (0.18±0.65) was significantly lower compared to PVB group (1.09±1.50) (p=0.009) at postoperative 12h. Accordingly, SSPB group reduced the dosage of PCIA (26.55±4.72ml) than PVB group (31.45±7.60ml) (p=0.046). Time consuming of PVB procedure was longer (11.14±1.66min) than DSPB (5.68±1.10min) and SSPB (4.77±1.04min) (p<0.001, respectively). PVB group was associated with more intraoperative atropine consumption (0.14±0.24mg) than DSPB group (0mg) (P=0.043). Conclusion: DSPB and SSPB are easy to perform and can serve as a promising alternative technique to PVB that may offer comparable analgesic effectiveness and a better side-effect profile for patients who undergoing VATS. Trial registration: This study was registered to Chinese Clinical Trials Registry on July 20, 2019. (Registration No: ChiCTR1900024678)

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).

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