Serratus anterior plane block for cardiothoracic surgeries: a meta-analysis of randomized trials

Ain-Shams Journal of Anesthesiology - Tập 13 Số 1 - 2021
Tarek Mostafa1, Ahmed M Abd El-Hamid2, Basem Abdelgawad3, Dina Hosny Elbarbary2
1Department of Anesthesiology and ICU, Tanta University Hospital, Tanta, Egypt
2Department of Anesthesiology and ICU, Benha University Hospital, Benha, Egypt
3Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University, Benha, Egypt

Tóm tắt

Abstract Background Comparison of serratus anterior plane block to different analgesic methods for anterolateral thoracic wall incisions. Meta-analysis was used to address this concern. Authors systemically searched the MEDLINE, EMBASE, PubMed, and Cochrane databases to identify all published randomized and prospective clinical trials, comparing the SAPB with other methods that used for analgesia in different thoracic surgical procedures and trauma. Results Ten studies were identified for inclusion in this study, involving a total of 735 patients. Meta-analysis showed that, compared with thoracic wall analgesia and PCA methods, the SAPB group resulted in a significant decrease in pain scores, significant decrease in consumption of analgesic drugs, and a significant decrease in the incidence of nausea and vomiting with no difference in the rate of hypotension. Conclusions The use of SAPB in cardiothoracic surgery and trauma is a safe and effective option for thoracic analgesia.

Từ khóa


Tài liệu tham khảo

Abd El-Hamid AM, Azab AF (2016) Intraoperative haemodynamic stability and stress response to surgery in patients undergoing thoracotomy: comparison between ultrasound-assisted thoracic paravertebral and epidural block. Egypt J Cardiothorac Anesth 10(2):36–41. https://doi.org/10.4103/1687-9090.192249

Chin KJ (2019) Thoracic wall blocks: from paravertebral to retrolaminar to serratus to erector spinae and back again–a review of the evidence. Best Pract Res Clin Anesthesiol. 33(1):67–77. https://doi.org/10.1016/j.bpa.2019.02.003

Durant E, Dixon B, Luftig J et al (2017) Ultrasound-guided serratus plane block for E.D. rib fracture pain control. Am J Emerg Med 35(1):197.e3–197.e6

Garg R (2017) Regional anaesthesia in breast cancer: benefits beyond pain. Indian J Anaesth 61(5):369–372. https://doi.org/10.4103/ija.IJA_292_17

Garg R, Bhan S, Vig S (2018 Apr) Newer regional analgesia interventions (fascial plane blocks) for breast surgeries: Review of literature. Indian J Anaesth 62(4):254–262. https://doi.org/10.4103/ija.IJA_46_18

Hanley C, Wall T, Bukowska I et al (2020) Ultrasound-guided continuous deep serratus anterior plane block versus continuous thoracic paravertebral block for perioperative analgesia in videoscopic-assisted thoracic surgery. Eur J Pain 24(4):828–838. https://doi.org/10.1002/ejp.1533

Higgins JP, Savović J, Page MJ, Elbers RG, Sterne JA (2019) Assessing risk of bias in a randomized trial. Cochrane Handb Syst Rev Interv. 23:205–228. https://doi.org/10.1002/9781119536604.ch8

Kaushal B, Chauhan S, Saini K, Bhoi D, Bisoi AK, Sangdup T, Khan MA (2019) Comparison of the efficacy of ultrasound-guided serratus anterior plane block, pectoral nerves II block, and intercostal nerve block for the management of postoperative thoracotomy pain after pediatric cardiac surgery. J Cardiothorac Vasc Anesth 33(2):418–425. https://doi.org/10.1053/j.jvca.2018.08.209

Khalil AE, Abdallah NM, Ghada MB, AHK T (2017) Ultrasound-guided serratus anterior plane block versus thoracic epidural analgesia for thoracotomy pain. J Cardiothorac Vasc Anesth. 31(1):152–158. https://doi.org/10.1053/j.jvca.2016.08.023

Kim DH, Oh YJ, Lee JG, Ha D, Chang YJ, Kwak HJ (2018) Efficacy of ultrasound-guided serratus plane block on postoperative quality of recovery and analgesia after video-assisted thoracic surgery: a randomized, triple-blind, placebo-controlled study. Anesth Analg 126(4):1353–1361. https://doi.org/10.1213/ANE.0000000000002779

Kunio T, Murouchi T, Yamamoto S et al (2018) Spread of injectate in ultrasound-guided serratus plane block: a cadaveric study. JA Clin Rep 4(1):10. https://doi.org/10.1186/s40981-018-0147-4

Lee J, Kim S (2019) The effects of ultrasound-guided serratus plane block, in combination with general anesthesia, on intraoperative opioid consumption, emergence time, and hemodynamic stability during video-assisted thoracoscopic lobectomy: a randomized prospective study. Medicine 98(18):e15385. https://doi.org/10.1097/MD.0000000000015385

Liu X, Song T, Xu HY, Chen X, Yin P, Zhang J (2020) The serratus anterior plane block for analgesia after thoracic surgery: a meta-analysis of randomized controlled trails. Medicine. 99(21):e20286. https://doi.org/10.1097/MD.0000000000020286

Mayes J, Davison E, Panahi P, Patten D, Eljelani F, Womack J, Varma M (2016) An anatomical evaluation of the serratus anterior plane block. Anaesthesia 71(9):1064–1069. https://doi.org/10.1111/anae.13549

Ökmen K, Ökmen BM (2018) Evaluation of the effect of serratus anterior plane block for pain treatment after video-assisted thoracoscopic surgery. Anaesth Critic Care Pain Med. 37(4):349–353. https://doi.org/10.1016/j.accpm.2017.09.005

Park MH, Kim JA, Ahn HJ, Yang MK, Son HJ, Seong BG (2018) A randomized trial of serratus anterior plane block for analgesia after thoracoscopic surgery. Anaesthesia 73(10):1260–1264. https://doi.org/10.1111/anae.14424

Piccioni F, Segat M, Falini S, Umari M, Putina O, Cavaliere L, Ragazzi R, Massullo D, Taurchini M, del Naja C, Droghetti A (2018 Mar) Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols. J Thorac Dis. 10(Suppl 4):S555–S563. https://doi.org/10.21037/jtd.2017.12.86

Reyad RM, Shaker EH, Ghobrial HZ et al (2019) The impact of ultrasound-guided continuous serratus anterior plane block versus intravenous patient-controlled analgesia on the incidence and severity of post-thoracotomy pain syndrome: a randomized, controlled study. Eur J Pain 24(1):159–170

Saad FS, El Baradie SY, Aliem M, Ali MM, Kotb TAM (2018) Ultrasound-guided serratus anterior plane block versus thoracic paravertebral block for perioperative analgesia in thoracotomy. Saudi J Anaesth. 12(4):565–570. https://doi.org/10.4103/sja.SJA_153_18

Semyonov M, Fedorina E, Grinshpun J, Dubilet M, Refaely Y, Ruderman L, Koyfman L, Friger M, Zlotnik A, Klein M, Brotfain E (2019) Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery. J Pain Res 12:953–960. https://doi.org/10.2147/JPR.S191263

van Geffen GJ, Bruhn J (2017) Continuous peripheral nerve blocks safe practice and management. In: Complications of Regional Anesthesia 2017. Springer, Cham, pp 167–185

Wan X, Wang W, Liu J, Tong T (2014) Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol. 14(1):135. https://doi.org/10.1186/1471-2288-14-135

Williams WH, Heir JS, Sekhon AK (2019) Long-acting local anesthetics for analgesia following thoracic surgery. In: Principles and Practice of Anesthesia for Thoracic Surgery 2019. Springer, Cham, pp 1029–1043

Zhang X, Zhang C, Zhou X, Chen W, Li J, Wang H, Liu J (2020) Analgesic effectiveness of perioperative ultrasound-guided serratus anterior plane block combined with general anesthesia in patients undergoing video-assisted thoracoscopic surgery: a systematic review and meta-analysis. Pain Med. 3(10):2412–2422. https://doi.org/10.1093/pm/pnaa125

Thông tin
Thông tin xuất bản

Ain-Shams Journal of Anesthesiology

Tập 13 Số 1

Thông tin tác giả