• Jungwon Lee, Deok Heon Lee, and Saeyoung Kim.
• Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine.
• Medicine (Baltimore). 2020 Dec 4; 99 (49): e22102.

BackgroundSerratus anterior plane block (SAPB) and intercostal nerve block (ICNB) are attractive options for multimodal analgesia in patients undergoing thoracoscopic surgery, but which block is superior remains unclear.ObjectiveThe present study aimed to assess the effect of SAPB versus ICNB on reducing postoperative pain after video-assisted thoracoscopic surgery (VATS) for lobectomy.MethodsThis prospective, randomized, active-intervention-controlled, subject-assessor-blinded, single-center, parallel-group trial allocated 18- to 80-year-old patients with American Society of Anesthesiologists status I to III to receive either SAPB or ICNB in a 1:1 ratio. The primary outcome was numerical pain rating scale (NRS) scores during the first 24 hours postoperatively. The secondary outcomes were postoperative cumulative doses of ketorolac and fentanyl, and the occurrence of postoperative adverse effects.ResultsAmong the 57 patients assessed for eligibility, 50 were randomly assigned in a 1:1 ratio. Due to conversion to open thoracotomy and patient-controlled analgesia pump failure, 4 patients were excluded and 46 were analyzed. The intergroup differences in NRS scores were not statistically significant at any time point. Cumulative consumptions of fentanyl and ketorolac were also not significantly different. No perioperative adverse events occurred. Postoperative complications were also absent, except for nausea (2/23 patients [8.7% in both groups]).ConclusionResults of the present study do not clarify whether SAPB or ICNB has a superior effect on reducing pain after VATS, thereby suggesting they may exert similar analgesic effects.

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