Analgesic efficacy and safety of erector spinae plane block versus serratus anterior plane block in breast surgery—a meta-analysis and systematic review of randomized controlled trials DOI Creative Commons
Samiullah Shaikh, Umm E. Salma Shabbar Banatwala,

P. G. Desai

et al.

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

Published: Dec. 18, 2024

Abstract Background Mastectomy and breast-conserving surgery are key interventions for breast cancer, a leading cause of cancer-related mortality in women. Many undergoing experience postoperative pain compromising their functionality quality life. While multiple management strategies available, evidence comparing the erector spinae (ESPB) serratus anterior plane blocks (SAPB) improving post-surgical cancer patients is limited. Therefore, we investigated efficacy safety these two regional anesthesia techniques. Methods After PROSPERO registration, systematically searched PubMed, Google Scholar, Cochrane Library until May 2024. Risk ratios (RR) were calculated dichotomous outcomes standard mean differences (SMD) or (MD) computed continuous data. RevMan Review Manager 5.4.1 was used data analysis generation forest plots as well funnel plots. The Bias tool 2.0 (18) Grades Recommendation, Assessment, Development, Evaluation (GRADE) guidelines to appraise evaluate (19). Results A total 9 randomized control trials enrolling 550 included. Static scores at 0, 6, 8, 12, 24 h after surgery, dynamic area under curve (AUC) static score all time points between 0 (SMD (HKSJ 95% CI) − 0.27 [− 0.99, 0.45]) did not significantly vary with either block. Postoperative morphine consumption first number requesting analgesia greater those receiving SAPB [MD: 1.41 (95% C.I. 2.70, 0.13), p = 0.03] [RR: 1.28 1.00, 1.63), 0.05], respectively. analgesic use among administered ESPB 1.55 h, 1.02, 2.09), < 0.01]. Patient satisfaction incidence nausea vomiting similar across both groups. Conclusions block comparable, reduces may be favorable option surgery.

Language: Английский

Advances in anesthesia techniques for postoperative pain management in minimally invasive cardiac surgery: an Expert opinion DOI
Kexin Yuan, Boqun Cui, Duomao Lin

et al.

Journal of Cardiothoracic and Vascular Anesthesia, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

Citations

0
Comparison of the pharmacokinetic variations of different concentrations of ropivacaine used for serratus anterior plane block in patients undergoing thoracoscopic lobectomy: a population pharmacokinetics analysis DOI Creative Commons
Ling Jing,

Chunfei Xu,

Lujia Tang

et al.

Frontiers in Pharmacology, Journal Year: 2025, Volume and Issue: 16

Published: March 26, 2025

Objective Ropivacaine serratus anterior plane block is widely used in clinical analgesia patients undergoing thoracoscopic surgery. Different concentrations of ropivacaine have different analgesic effects, and the safety highly correlated with plasma concentration. In this study, nonlinear mixed effects modeling (NONMEM) method was to investigate population pharmacokinetics (PPK) characteristics explored relationship between covariates on pharmacokinetic parameters ropivacaine, order provide a theoretical basis for rational use ropivacaine. Methods This study approved by Ethics Committee First People’s Hospital Changzhou. The informed consent obtained. A total 43 who underwent pneumonectomy our hospital from April December 2023 were included. Patients randomly assigned four concentration groups 0.25%, 0.375%, 0.5%, 0.75%, respectively, administered dose 3 mg/kg. Arterial blood taken at 1, 15, 30, 45 min, 2, 4, 8, 12, 24 h after administration through superficial block. detected liquid chromatography-tandem mass spectrometry (LC-MS/MS). PPK model constructed NONMEM. final verified using goodness fit, visual predictive check (VPC) normalized distribution error (NPDE). Monte Carlo simulation applied evaluate optimize dosing regimens. Results 388 data 41 establish model. Eighteen other two external validation. two-compartment zero-order first-order absorption best proportion 27.4%, time 0.49 infusion 0.015 h. rate constant (ka)was ka 32.0, 19.4 14.4 −1 0.75% which indicating that peak (T max ) low-concentration significantly shortened. Other results as follows: CL/F(L/h) = 7.475, Vc/F(L) 125, Q/F(L/h) 14.7, Vp/F(L) 197. addition, platelet count has an effect Vc/F. demonstrate recommended not exceed 300 mg avoid occurrence adverse reactions. Conclusion first pulmonary resection. exhibits excellent stability reliability, thereby offering valuable insights into personalized drug administration. significant impacts

Language: Английский

Citations

0
What is new in cardiac anesthesia in 2024? DOI Creative Commons

Zhaoyi Tang,

Andrew N. Lin,

Henry Liu

et al.

Journal of Anesthesia and Translational Medicine, Journal Year: 2025, Volume and Issue: 4(2), P. 33 - 41

Published: April 12, 2025

Language: Английский

Citations

0
Postoperative pain management after thoracic transplantations DOI
Clara Lobo, Boris Tufegdzic

Current Opinion in Anaesthesiology, Journal Year: 2024, Volume and Issue: 37(5), P. 493 - 503

Published: July 31, 2024

Purpose of review Heart and lung transplantation evolution marked significant milestones. Pioneering efforts Dr Christiaan Barnard with the first successful heart transplant in 1967, followed by advancements heart–lung single-lung transplants Drs Bruce Reitz, Norman Shumway, Joel Cooper laid groundwork for contemporary organ transplantation, offering hope patients end-stage pulmonary diseases. Recent findings Pretransplant opioid use recipients is linked to higher mortality dependence posttransplant. Effective pain control crucial reduce opioid-related adverse effects enhance recovery. However, research on specific management protocols limited. In effective crucial. Studies emphasize benefits multimodal strategies, including thoracic epidural analgesia paravertebral blocks, recovery use. Perioperative challenges are unique necessitate careful consideration prevent complications improve outcomes. Summary This emphasizes importance tailored recipients. It advocates extended follow-up alternative analgesics minimize dependency quality life. Further high-quality needed optimize postoperative patient

Language: Английский

Citations

2
Recent Advances in Perioperative Analgesia in Thoracic Surgery: A Narrative Review DOI Open Access
John Mitchell,

Céline Couvreur,

Patrice Forget

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 14(1), P. 38 - 38

Published: Dec. 25, 2024

Thoracic surgery is associated with significant postoperative pain, which can hinder recovery and elevate morbidity risks. Traditionally, epidural anesthesia has been the cornerstone for pain management, but its drawbacks including technical challenges, side effects, complications necessitate exploring alternative methods. This narrative review examined recent advances in perioperative analgesic strategies thoracic surgery, focusing on regional anesthetic techniques like paravertebral blocks (PVBs), erector spinae plane (ESPBs), intercostal blocks, serratus anterior blocks. Each approach was evaluated efficacy, safety, impact patient outcomes. PVB provide effective unilateral analgesia fewer systemic compared to epidurals. ESPB provides through a superficial, ultrasound-guided approach, minimizing risks offering an various procedures. Intercostal are limited by need multiple injections, increasing complication Serratus targeting nerves, show promise managing lateral wall low rate. Advancements surgical minimally invasive approaches further optimize control recovery. A multimodal combining therapies enhances outcomes addressing somatic visceral components. Despite efficacy of analgesia, offer comparable relief complications, suggesting their growing role surgery. Collaborative efforts between surgical, anesthetic, emergency teams crucial tailoring management individual patients, improving reducing long-term morbidity. Future research should continue these methods refine application broaden accessibility.

Language: Английский

Citations

1
Analgesic efficacy and safety of erector spinae plane block versus serratus anterior plane block in breast surgery—a meta-analysis and systematic review of randomized controlled trials DOI Creative Commons
Samiullah Shaikh, Umm E. Salma Shabbar Banatwala,

P. G. Desai

et al.

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

Published: Dec. 18, 2024

Abstract Background Mastectomy and breast-conserving surgery are key interventions for breast cancer, a leading cause of cancer-related mortality in women. Many undergoing experience postoperative pain compromising their functionality quality life. While multiple management strategies available, evidence comparing the erector spinae (ESPB) serratus anterior plane blocks (SAPB) improving post-surgical cancer patients is limited. Therefore, we investigated efficacy safety these two regional anesthesia techniques. Methods After PROSPERO registration, systematically searched PubMed, Google Scholar, Cochrane Library until May 2024. Risk ratios (RR) were calculated dichotomous outcomes standard mean differences (SMD) or (MD) computed continuous data. RevMan Review Manager 5.4.1 was used data analysis generation forest plots as well funnel plots. The Bias tool 2.0 (18) Grades Recommendation, Assessment, Development, Evaluation (GRADE) guidelines to appraise evaluate (19). Results A total 9 randomized control trials enrolling 550 included. Static scores at 0, 6, 8, 12, 24 h after surgery, dynamic area under curve (AUC) static score all time points between 0 (SMD (HKSJ 95% CI) − 0.27 [− 0.99, 0.45]) did not significantly vary with either block. Postoperative morphine consumption first number requesting analgesia greater those receiving SAPB [MD: 1.41 (95% C.I. 2.70, 0.13), p = 0.03] [RR: 1.28 1.00, 1.63), 0.05], respectively. analgesic use among administered ESPB 1.55 h, 1.02, 2.09), < 0.01]. Patient satisfaction incidence nausea vomiting similar across both groups. Conclusions block comparable, reduces may be favorable option surgery.

Language: Английский

Citations

0