• Guodong Chen, Yufang Li, Yixiao Zhang, and Xiangming Fang.
• Department of Anesthesiology and Intensive Care, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, People's Republic of China.
• J Pain Res. 2019 Jan 1; 12: 2411-2417.

BackgroundSerratus anterior plane (SAP) block is a relatively novel technique that can block the lateral cutaneous branches of the intercostal nerves as well as the long thoracic nerve.PurposeOur study aimed to evaluate the effects of SAP block on postoperative pain after thoracoscopic surgery compared with local anesthetic (LA) infiltration.Patients And MethodsForty adult patients undergoing video-assisted thoracic surgery were randomized to receive either SAP block (n=20) or LA infiltration of incision (n=20). The primary outcome was postoperative visual analog scale (VAS) score at the 2nd, 8th, 16th, 24th, and 48th hour after surgery. The secondary outcomes were the consumption of sufentanil at 8th, 16th, 24th hours postoperative. In addition, rescue analgesia, drug-related adverse effects after surgery was also analyzed.ResultsThe SAP group showed lower VAS scores at the 2nd hour (at rest: SAP group 11 [8-13] vs LA group 28 [26-32], P=0.01; on coughing: 15 [13-18] vs 33 [26-38], P=0.01) and the 8th hour (at rest: 13 [12-18] vs 36 [32-46], P=0.01; on coughing: 19 [16-23] vs 42 [36-53], P=0.01) after surgery. Postoperative sufentanil consumption in the SAP group during 0-8 hrs was significantly lower compared with the LA group (P<0.01). The use of rescue analgesia was also significantly lower in the SAP group (P=0.02) during 0-12 hrs.ConclusionCompared to LA infiltration, ultrasound-guided SAP block may provide better pain relief as well as reduce opioid consumption after thoracoscopic surgery.

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