The effect of postoperative serratus anterior plane block on postoperative analgesia in patients undergoing breast surgery.

Objectives This study aimed to evaluate the effect of serratus anterior plane block (SAP) on postoperative morphine consumption. We aimed to determine the differences between both similar blocks and evaluate the effect of the methods of application of this block on patients' postoperative pain scores and morphine consumption. Material and Methods This study is a single-center, prospective and observational study performed with 40 volunteer patients with American Society of Anesthesiologists (ASA) I-III, who were 18-70 years of age, scheduled for breast surgery. A total of 40 patients who underwent general anesthesia were divided into two groups each with 20 patients. While SAP block was applied to the study group, no block was applied to the control group. SAP block was made by injecting a total of 40 ml of 0.25% bupivacaine between 2 muscles after the test dose was injected with saline. All patients were followed up for 12 hours postoperatively with patient-controlled analgesia (PCA) pump. Morphine consumption, visual analogue score (VAS) values and side effects were recorded at the postoperative 1st, 6th and 12th hours. Results There was no significant difference between the two groups in terms of hemodynamic parameters and demographic data. Postoperative morphine consumption and postoperative analgesic requirement were significantly lower in the SAP block group (p <0.001). Postoperative VAS values were significantly lower in the SAP block group (p <0.001). No complication was observed related to the block. Conclusion It was found that the SAP block reduced morphine consumption, significantly decreased VAS values, and reduced side effects due to opioids postoperatively.

[1]  E. Çelik,et al.  Preemptive Analgesic Efficacy of the Ultrasound-Guided Bilateral Superficial Serratus Plane Block on Postoperative Pain in Breast Reduction Surgery: A Prospective Randomized Controlled Study , 2019, Aesthetic plastic surgery.

[2]  N. Berbenetz,et al.  The serratus plane block for postoperative analgesia in breast and thoracic surgery: a systematic review and meta-analysis , 2019, Regional Anesthesia & Pain Medicine.

[3]  Yan-qing Chen,et al.  Ultrasound-guided serratus plane block enhances pain relief and quality of recovery after breast cancer surgery: A randomised controlled trial , 2019, European journal of anaesthesiology.

[4]  A. Chakraborty,et al.  Ultrasound-guided modified serratus anterior plane block for perioperative analgesia in breast oncoplastic surgery: A case series , 2019, Indian journal of anaesthesia.

[5]  A. Bhatia,et al.  Pectoralis and Serratus Fascial Plane Blocks Each Provide Early Analgesic Benefits Following Ambulatory Breast Cancer Surgery: A Retrospective Propensity-Matched Cohort Study , 2017, Anesthesia and analgesia.

[6]  M. Yamakage,et al.  Injection Volume and Anesthetic Effect in Serratus Plane Block , 2017, Regional Anesthesia & Pain Medicine.

[7]  A. Prats-Galino,et al.  Serratus plane block: a novel ultrasound‐guided thoracic wall nerve block , 2013, Anaesthesia.

[8]  R. Blanco The ‘pecs block’: a novel technique for providing analgesia after breast surgery , 2011, Anaesthesia.

[9]  Henrik Kehlet,et al.  Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention. , 2011, The journal of pain : official journal of the American Pain Society.

[10]  P. Kranke,et al.  Efficacy and safety of paravertebral blocks in breast surgery: a meta-analysis of randomized controlled trials. , 2010, British journal of anaesthesia.

[11]  T. Eberlein,et al.  Thoracic Epidural Anesthesia Improves Outcome After Breast Surgery , 1993, Annals of surgery.

[12]  M. Karmakar,et al.  Thoracic Paravertebral Block , 2001, Anesthesiology.