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12 January 2024 : Clinical Research  

Evaluating Modified Ultrasound-Guided Serratus Anterior Plane Block for Enhanced Postoperative Recovery in Thoracoscopic Lobectomy Patients

Haihong Yang1AEG, Qin Zhang2BE, Kui Gao1BC, Peng Zha1BD, Huaqu Gong1DF, Xuemei Dai1CDF, Yinghai Liu1BF, Jingya Luo3BD, Gong Gu1A, Yongjian Yang4AE*

DOI: 10.12659/MSM.942757

Med Sci Monit 2024; 30:e942757

Abstract

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BACKGROUND: Thoracoscopic lobectomy is accompanied by intense trauma and pain due to impaired chest wall integrity. We aimed to introduce a modified ultrasound-guided serratus anterior plane block (MUG-SAPB) for postoperative analgesia in patients who underwent thoracoscopic lobectomy, and to determine whether it could effectively alleviate postoperative pain and improve recovery quality.

MATERIAL AND METHODS: Overall, 78 patients randomly received either combined MUG-SAPB (0.25% ropivacaine, 10 mg dexamethasone, 40 mL) with patient-controlled intravenous analgesia (PCIA) or received PCIA alone. The primary outcomes were visual analog scale (VAS) scores at rest and during movement at 4, 8, 12, 20, 24, 48, and 72 h postoperatively. The secondary outcomes included use of opioids during surgery, numbers of rescue analgesics (butorphanol), frequency of patient-controlled analgesia (PCA), comfort score within 24 h postoperatively, and postoperative complications within 72 h.

RESULTS: Compared to the PCIA group, in the MUG-SAPB group, resting VAS scores at 4-24 h (P<0.05) and movement VAS scores at 4-12 h postoperatively (P<0.05) were lower; intraoperative use of sufentanil and frequency of PCA were less, and less rescue analgesia was used (P=0.02, P=0.04 and P=0.03, respectively). Patients in the MUG-SAPB group had faster first mobilization (P=0.04). The MUG-SAPB group had higher comfort scores than the PCIA group (P=0.03). None of the MUG-SAPB patients had any SAPB-related complications.

CONCLUSIONS: MUG-SAPB effectively relieved postoperative pain, reduced opioid consumption, and accelerated early ambulation in comparison with PCIA alone in patients who underwent thoracoscopic lobectomy.

Keywords: Pain, Postoperative, Nerve Block

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DOI: 10.12659/MSM.943911

Med Sci Monit 2024; 30:e943911

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750