Analgesic efficacy and safety of erector spinae versus serratus anterior plane block in thoracic surgery: a systematic review and meta-analysis of randomized controlled trials

Journal of Anesthesia Analgesia and Critical Care, Journal Year: 2024, Volume and Issue: 4(1)

Published: Jan. 12, 2024

Abstract Background Erector spinae plane block (ESPB) and serratus anterior (SAPB) are regional anesthesia techniques that have shown favorable results in pain management following thoracic surgeries; however, their relative superiority is unclear. This review (PROSPERO: CRD42023443018) aims to compare the analgesic efficacy of ESPB SAPB patients undergoing surgeries through pooled analysis co-primary outcomes: postoperative oral-morphine-equivalent (mg) consumption 24 h scores (static) at h. Methods A literature search was conducted across PubMed, Cochrane Library, Google Scholar identify randomized controlled trials (RCTs) from inception May 2023, comparing surgeries. Statistical pooling done using Review Manager 5.4.1. Bias assessment employed Collaboration Risk-of-Bias 2.0 tool. The strength evidence assessed guidelines GRADE working group. Results Nine RCTs (485 patients) were included study. Postoperative (mean difference (MD) = − 0.31 [− 0.57, 0.05], p 0.02) (MD 19.73 25.65, 13.80], < 0.00001) significantly lower ESBP However, MDs did not exceed set threshold for clinical importance. No significant differences observed opioid-related adverse effects block-related complications. Conclusion Our statistically imply has superior compared SAPB; this clinically unimportant. safety profile two blocks comparable; hence, current cannot define one over other. findings warrant further research with standardized methodologies a longer duration yield robust better applications.

Language: Английский

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Efficacy of serratus posterior superior intercostal plane block (SPSIPB) on post-operative pain and total analgesic consumption in patients undergoing video-assisted thoracoscopic surgery (VATS): A double-blinded randomised controlled trial

Indian Journal of Anaesthesia, Journal Year: 2023, Volume and Issue: 67(12), P. 1116 - 1122

Published: Dec. 1, 2023

Serratus posterior superior intercostal plane block (SPSIPB) is a novel technique that can provide analgesia in the hemithorax, shoulder, and back of neck. This study aimed to evaluate post-operative analgesic effect SPSIPB patients undergoing video-assisted thoracoscopic surgery (VATS).

Language: Английский

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Comparison of the analgesic efficacy of ultrasound-guided superficial serratus anterior plane block and intercostal nerve block for rib fractures: a randomized controlled trial

BMC Anesthesiology, Journal Year: 2025, Volume and Issue: 25(1)

Published: March 13, 2025

Various regional analgesic methods are frequently incorporated into multimodal analgesia strategies for managing rib fractures. This study aimed to compare the efficacy of ultrasound-guided superficial serratus anterior plane block (S-SAPB) and intercostal nerve (ICNB) in patients with isolated randomized controlled trial included aged 18–65 years unilateral fractures (≤ 6 ribs) resulting from trauma. Patients underwent S-SAPB (20 ml 0.25% bupivacaine) or ICNB (3 bupivacaine each fractured rib). Pain levels were assessed using Visual Analogue Scale (VAS) both prior procedure (Pre-Block, (T0)) at specific time points following intervention: 1st hour (T1), 2nd (T2), 4th (T4), 8th (T8), 16th (T16), 24th (T24). The changes observed values over expressed as delta (Δ). Both provided effective analgesia. In first 4 h, demonstrated a greater reduction VAS scores, particularly 10th 11th However, resulted significantly longer-lasting analgesia, pain relief after 8 h (T8–T24) compared (p < 0.05). group required no additional whereas 43.3% supplemental tramadol 0.001). techniques well tolerated, reported complications. provides prolonged may be preferable fracture beyond initial h. offers superior early postoperative period, especially lower (10th–11th ribs). A combined approach that includes blocks optimize control multiple involving ribs.

Language: Английский

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Thoracic fascial plane injections using a “hit-rib” technique in dog cadavers targeting lateral cutaneous nerves

Veterinary Anaesthesia and Analgesia, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

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Erector Spinae Plane Block Combined with Serratus Anterior Plane Block Versus Thoracic Paravertebral Block for Postoperative Analgesia and Recovery After Thoracoscopic Surgery: A Randomized Controlled Non-inferiority Clinical Trial

Current Medical Science, Journal Year: 2023, Volume and Issue: 43(3), P. 615 - 622

Published: May 26, 2023

Language: Английский

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Effectiveness of Surgeon-Performed Paravertebral Block Analgesia for Minimally Invasive Thoracic Surgery

JAMA Surgery, Journal Year: 2023, Volume and Issue: 158(12), P. 1255 - 1255

Published: Oct. 25, 2023

In minimally invasive thoracic surgery, paravertebral block (PVB) using ultrasound (US)-guided technique is an efficient postoperative analgesia. However, it operator-dependent process depending on experience and local resources. Because pain-control failure highly detrimental, surgeons may consider other locoregional analgesic options.

Language: Английский

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Comparison of efficacy of erector spinae plane block, thoracic paravertebral block, and erector spinae plane block and thoracic paravertebral block combination for acute pain after video-assisted thoracoscopic surgery: a randomized controlled study

Minerva Anestesiologica, Journal Year: 2022, Volume and Issue: 89(3)

Published: June 29, 2022

BACKGROUND: The aim of this study was to compare the efficacy ultrasound-guided erector spinae plane block (ESPB), thoracic paravertebral (TPVB), and ESPB TPVB combination on acute pain after video-assisted thoracoscopic surgery (VATS).METHODS: Seventy-five patients were evaluated (three groups: ESPB, TPVB, or combined ESPB-TPVB [comb-group], each 25 patients). All interventions performed with same volume bupivacaine (20 mL). Primary outcome VAS (Visual Analog Scale) during first 24 hours. Secondary outcomes postoperative morphine consumption rescue analgesic requirements.RESULTS: rest coughing significantly higher compared other groups (in all measurements comb-group; in but hours measurement ESPB) comb-group had similar (e.g., median at 8th hour: 3-4-2 [P=0.014] 2-3-1 [P<0.001], respectively). Morphine statistically than (ESPB: 15.28 mg; TPVB: 19.30 ESPB+TPVB: 10.00 mg) (P=0.003). Rescue requirement group (P=0.009).CONCLUSIONS: alone provided superior primary alone. consumptions comb-group. terms secondary outcomes. This is one studies using ESBP for VATS, shows approach.

Language: Английский

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Comparison of erector spinae plane block and serratus anterior plane block for postoperative analgesia in uniportal thoracoscopic lobectomy: a randomized controlled trial

BMC Anesthesiology, Journal Year: 2023, Volume and Issue: 23(1)

Published: Dec. 1, 2023

Abstract Background Postoperative pain remains a significant concern following uniportal thoracoscopic surgery. The analgesic efficacy of erector spinae plane block (ESPB) and serratus anterior (SAPB) in terms postoperative opioid consumption surgery still needs further studies. Methods A randomized controlled trial was conducted, enrolling 150 patients who underwent lobectomy. were randomly allocated to three groups 1:1:1 ratio: the ESPB group (administered 20 ml 0.5% ropivacaine), SAPB standard care (control) group. primary endpoint sufentanil during first 24 h Secondary endpoints assessed area under curve (AUC) numerical rating scale (NRS) scores, occurrence moderate severe pain, time initial request, adverse events. Results No difference observed between (adjusted difference, 1.53 [95% CI, -5.15 2.08]). However, comparison control group, both intervention demonstrated decrease consumption, with adjusted differences -9.97 -13.10 -6.84] for -12.55 -15.63 -9.47] There no AUC NRS scores rest movement groups, -7.10 1.33 -15.55] condition 5.61 -13.23 2.01] condition. At 6 postoperatively, there fewer compared those -1.37% -2.29% -0.45%]. request significantly differed among (ESPB vs Control P < 0.01, = 0.015). Conclusions In undergoing lobectomy, although two are not statistically significant, demonstrate effective reduction need rescue analgesics Moreover, experienced lower incidence at postoperatively Trial registration study registered Chinese Clinical Registry (registration No: ChiCTR1900021695, Date registration: March 5th, 2019).

Language: Английский

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Comparison of combined deep and superficial serratus anterior block with thoracic paravertebral block for postoperative pain in patients undergoing video-assisted thoracoscopic surgery

TURKISH JOURNAL OF MEDICAL SCIENCES, Journal Year: 2024, Volume and Issue: 54(5), P. 1021 - 1032

Published: Oct. 18, 2024

Thoracic paravertebral block (TPVB) is a well-established procedure for the management of postoperative pain in patients undergoing video-assisted thoracic surgery (VATS). In recent years, there have been studies suggesting that fascial plane blocks may be an alternative to TPVB. The objective our study was determine efficacy combined deep and superficial serratus anterior (C-SAPB) as TPVB analgesia VATS.

Language: Английский

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Analgesic Efficacy of Combined Thoracic Paravertebral Block and Erector Spinae Plane Block for Video-Assisted Thoracic Surgery: A Prospective Randomized Clinical Trial

Medical Science Monitor, Journal Year: 2023, Volume and Issue: 29

Published: May 30, 2023

BACKGROUND:Thoracic paravertebral block (TPVB) and erector spinae plane (ESPB) are widely used in video-assisted thoracic surgery (VATS). However, they have corresponding adverse effects, including hypotension for TPVB unpredictable injectate spread ESPB. An optimal perioperative analgesic strategy remains controversial. We investigated the effect of ultrasound-guided combined ESPB (CTEB) VATS. MATERIAL AND METHODS:A total 120 patients scheduled were randomized to receive either TPVB, ESPB, or CTEB preoperatively. Postoperative analgesia was achieved with sufentanil patient-controlled intravenous analgesia. The primary outcome static pain score at 2 h after surgery. RESULTS:The postoperatively significantly different among 3 groups. This difference statistically significant Group vs (P=0.004), but not (P=0.767), (P=0.117). exhibited highest incidence More experienced a sensory loss Groups 30 min performance. Patients receiving lower chronic 6 months than those CONCLUSIONS:CTEB does enhance undergoing VATS; however, it may induce faster nerve reduce postoperative compared also help intraoperative TPVB.

Language: Английский

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