AI Article Synopsis

  • The study assessed how adding a serratus anterior plane block could affect morphine use and pain management after video-assisted thoracoscopic surgery.
  • A total of 64 patients were included, with those receiving both the serratus anterior plane block and intrathecal morphine using significantly less morphine and reporting lower pain scores in the first 12 hours post-surgery.
  • The findings suggest that combining these two methods provides better pain relief during the early postoperative period, making it a safe and effective approach.

Article Abstract

Background: The aim of this study was to evaluate the effect of serratus anterior plane block in addition to intrathecal morphine for early postoperative period after video-assisted thoracoscopic surgery on the amount of morphine consumption and the Visual Analog Scale scores.

Methods: This single-blind, randomized-controlled study included a total of 64 patients (39 males, 25 females; mean age: 53.6±17.0 years; range, 20 to 89 years) who were scheduled for video-assisted thoracoscopic surgery in a tertiary hospital between September 2019 and March 2020. Postoperative pain control was achieved with intrathecal morphine 0.6 mg addition to serratus anterior plane block (Group ITM+SAPB) or with only intrathecal morphine (Group ITM) after an induction of anesthesia. The serratus anterior plane block was performed with a single injection of 0.4 mL/kg of 0.25% bupivacaine at the level of fifth rib with ultrasound guidance. Morphine consumption, pain scores, and side effects were recorded in the postoperative period.

Results: The mean morphine consumption was significantly lower in the ITM+SAPB group at all time points. Compared to the control group, the Visual Analog Scale-resting and coughing scores were significantly lower in the first 12 h after surgery. Pain scores were significantly higher in the ITM+SAPB group in patients where the trocar was inserted at upper level of the fifth rib than the lower level (3-5 vs. 5-8) during the first 6 h after surgery.

Conclusion: The use of serratus anterior plane block in addition to intrathecal morphine is a safe and effective way to improve pain control for early postoperative period after video-assisted thoracoscopic surgery. The serratus anterior plane block ensures better analgesia until the peak effect of spinal morphine occurs.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8762897PMC
http://dx.doi.org/10.5606/tgkdc.dergisi.2021.20804DOI Listing

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