Abstract
Background
The deep serratus anterior plane blockade (SAPB) is a promising novel regional anaesthesia technique for blockade of the anterolateral chest wall. Evidence for the efficacy of SAPB versus other analgesic techniques in thoracic surgery remains inadequate.
Aims
This study compared ultrasound‐guided continuous SAPB with a surgically‐placed continuous thoracic paravertebral block (SPVB) technique in patients undergoing videoscopic‐assisted thoracic surgery (VATS).
Methods
In a single‐centre, double‐blinded, randomised, non‐inferiority study we allocated 40 patients undergoing VATS to either SAPB or SPVB, with both groups receiving otherwise standardised treatment, including multimodal analgesia. The primary outcome was 48‐hour opioid consumption. Secondary outcomes included numerical rating scores (NRS) for postoperative pain, patient‐reported “worst pain score” (WPS) as well as functional measures (including mobilisation distance and cough strength).
Results
48‐hour opioid consumption for the SAPB group was non‐inferior compared with SPVB. SAPB was associated with improved NRS pain scores at rest, with cough and with movement at 24‐hours postoperatively (p=0.007, p=0.001 and p=0.012 respectively). SAPB was also associated with a lower “worst pain score” (p=0.008). Day 1 walking distance (D1WD) was improved in the SAPB group (p=0.012), whereas the difference in cough strength did not reach statistical significance (p=0.071). There was no difference in haemodynamics, opioid side‐effects, length of hospital stay, or patient satisfaction between the two groups.
Conclusions
The SAPB, as part of a multimodal analgesia regimen, is non‐inferior in terms of 48‐hour opioid consumption compared to SPVB and is associated with improved functional measures in thoracic surgical patients.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/2ufmUfA
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