Relative perioperative analgesic efficacy of single-shot serratus anterior plane block versus thoracic paravertebral block in breast and thoracic surgeries – A systematic review and meta-analysis of randomised controlled trials

Indian Journal of Anaesthesia, Год журнала: 2025, Номер 69(1), С. 54 - 64

Опубликована: Янв. 1, 2025

Various regional analgesia techniques, such as thoracic paravertebral (TPV) and serratus anterior plane (SAP) blocks, have been employed to manage postoperative pain following chest wall surgery. However, the comparative analgesic efficacy of these two approaches remains uncertain. This systematic review meta-analysis aimed assess relative blocks in surgeries, including breast procedures. The primary objective was time first rescue analgesia, secondary encompassed opioid consumption within 24 h, scores at different intervals, opioid-related adverse effects block-related complications. A search for randomised controlled trials (RCTs) conducted PubMed, EMBASE Scopus databases, covering studies from their inception September 2023. We included active treatment arms RCTs comparing modalities. Statistical analysis Review Manager Version 5.3, results were analysed reported separately surgery subgroups. Eighteen enroling 1141 patients included. Overall, no significant difference observed with a mean 0.69 h (95% confidence interval -1.83, 0.45; P = 0.24, I 2 98%) between SAP TPV block groups. demonstrated superior outcomes patients. Complications related pleural puncture haematoma injection site. evidence suggests that both generally offer comparable patients, providing slight advantage those undergoing

Язык: Английский

Bayesian Network Meta-Analysis of Postoperative Analgesic Techniques in Thoracoscopic Lung Resection Patients

Pain and Therapy, Год журнала: 2025, Номер unknown

Опубликована: Фев. 22, 2025

Postoperative analgesia in thoracoscopic lung resection is crucial, with several nerve block techniques—including thoracic epidural anesthesia (TEA), paravertebral (PVB), erector spinae plane (ESPB), intercostal (INB), and serratus anterior (SAPB)—commonly employed. However, there remains ongoing debate regarding the optimal technique. To evaluate compare effectiveness of these methods, a systematic review was conducted across multiple databases, including PubMed, Embase, Web Science, Cochrane Library, identifying relevant randomized clinical trials (RCTs). A Bayesian network meta-analysis performed to assess postoperative pain management, subgroup analyses meta-regression examine key factors influencing outcomes, such as risk bias, continuous catheter analgesia, patient-controlled (PCA). The results revealed that for 12-h resting visual analog scale (VAS) scores, surface under cumulative ranking curve (SUCRA) TEA > PVB ESPB control INB SAPB, whereas at 24 h, it shifted SAPB. For coughing VAS ranked highest, followed by PVB, ESPB, control. At TEA, INB, inconsistency test showed good consistency, minimal publication neither study quality nor local anesthetic infiltration incision site significantly impacted outcomes. Excluding studies without PCA did not change SUCRA rankings. consistently highest 24-h scores. Clustered plots indicated were most suitable techniques analgesia. emerged analgesic resection. While superior efficacy, offered fewer side effects, providing safety advantage. considered less due its excessive effects.

Язык: Английский

Serratus Anterior Plane Block for Pain Management After Video-Assisted Thoracoscopic Surgeries: A Narrative Review

Medicina, Год журнала: 2025, Номер 61(6), С. 1010 - 1010

Опубликована: Май 28, 2025

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive diagnostic and therapeutic procedure utilized in various thoracic conditions. VATS has grown popularity with ever-expanding knowledge of enhanced recovery after (ERAS) protocols its benefits regarding patient care outcomes. Pain control following utmost importance to minimize the complication risk. Options for pain have traditionally included systemic IV analgesia but evolved include loco-regional as well. The serratus anterior plane block (SAPB) one form that been shown provide effective anterolateral chest wall. Patients who received SAPB compared methods anesthesia demonstrated significant decreases postoperative opioid consumption. offers promising safety profile typically more superficial than other types analgesia. This review outlines recent literature surrounding use VATS.

Язык: Английский