DOI QR코드

DOI QR Code

Serratus Anterior Plane (SAP) Block Used for Thoracotomy Analgesia: A Case Report

  • Okmen, Korgun (AIBU Izzet Baysal Education and Research Hospital, Anesthesiology and Reanimation) ;
  • Okmen, Burcu Metin (AIBU Izzet Baysal Physical Medicine and Rehabilitation Education and Research Hospital, Physical Medicine and Rehabilitation) ;
  • Uysal, Serkan (AIBU Izzet Baysal Education and Research Hospital, Thoracic Surgery)
  • 투고 : 2015.10.08
  • 심사 : 2016.02.05
  • 발행 : 2016.07.01

초록

Thoracotomy is a surgical technique used to reach the thoracic cavity. Management of pain due to thoracotomy is important in order to protect the operative respiratory reserves and decrease complications. For thoracotomy pain, blocks (such as thoracic epidural, paravertebral, etc.) and pleural catheterization and intravenous drugs (such as nonsteroidal anti-inflammatory drugs [NSAIDs], and opioids, etc., can be used. We performed a serratus anterior plane (SAP) block followed by catheterization for thoracotomy pain. We used 20 ml 0.25% bupivacaine for analgesia in a patient who underwent wedge resection for a lung malignancy. We provided analgesia for a period of close to seven hours for the patient, whose postoperative VAS (visual analog scale) scores were recorded. We believe that an SAP block is effective and efficient for the management of pain after thoracotomy.

키워드

참고문헌

  1. Slinger PD, Campos JH. Anesthesia for thoracic surgery. In: Miller's anesthesia. 8th ed. Edited by Miller RD. Philadelphia (PA), Elsevier Saunders. 2015, pp 1942-2006.
  2. Blanco R. The 'pecs block': a novel technique for providing analgesia after breast surgery. Anaesthesia 2011; 66: 847-8.
  3. Gharaei H, Imani F, Almasi F, Solimani M. The effect of ultrasound-guided TAPB on pain management after total abdominal hysterectomy. Korean J Pain 2013; 26: 374-8. https://doi.org/10.3344/kjp.2013.26.4.374
  4. Blanco R, Parras T, McDonnell JG, Prats-Galino A. Serratus plane block: a novel ultrasound-guided thoracic wall nerve block. Anaesthesia 2013; 68: 1107-13. https://doi.org/10.1111/anae.12344
  5. Gulbahar G, Kocer B, Muratli SN, Yildirim E, Gulbahar O, Dural K, et al. A comparison of epidural and paravertebral catheterisation techniques in post-thoracotomy pain management. Eur J Cardiothorac Surg 2010; 37: 467-72.
  6. Lonnqvist PA, MacKenzie J, Soni AK, Conacher ID. Paravertebral blockade. Failure rate and complications. Anaesthesia 1995; 50: 813-5. https://doi.org/10.1111/j.1365-2044.1995.tb06148.x
  7. Schneider RF, Villamena PC, Harvey J, Surick BG, Surick IW, Beattie EJ. Lack of efficacy of intrapleural bupivacaine for postoperative analgesia following thoracotomy. Chest 1993; 103: 414-6. https://doi.org/10.1378/chest.103.2.414
  8. Lopez-Matamala B, Fajardo M, Estebanez-Montiel B, Blancas R, Alfaro P, Chana M. A new thoracic interfascial plane block as anesthesia for difficult weaning due to ribcage pain in critically ill patients. Med Intensiva 2014; 38: 463-5. https://doi.org/10.1016/j.medin.2013.10.005
  9. Kunhabdulla NP, Agarwal A, Gaur A, Gautam SK, Gupta R, Agarwal A. Serratus anterior plane block for multiple rib fractures. Pain Physician 2014; 17: E651-3.

피인용 문헌

  1. Regional Techniques for Thoracic Wall Surgery vol.7, pp.2, 2017, https://doi.org/10.1007/s40140-017-0212-y
  2. Ultrasound-Guided Serratus Plane Block and Fast-Track Tracheal Extubation in the Operating Room for Thoracic Trauma Patients vol.9, pp.11, 2017, https://doi.org/10.1213/XAA.0000000000000600
  3. Has analgesia changed for lung resection surgery? vol.73, pp.4, 2018, https://doi.org/10.1111/anae.14188
  4. Serratus anterior plane block for minimal invasive heart surgery vol.18, pp.1, 2018, https://doi.org/10.1186/s12871-018-0614-5
  5. Too Deep or Not Too Deep? pp.1098-7339, 2018, https://doi.org/10.1097/AAP.0000000000000768
  6. Efficacy of Ultrasound-Guided Serratus Plane Block on Postoperative Quality of Recovery and Analgesia After Video-Assisted Thoracic Surgery vol.126, pp.4, 2018, https://doi.org/10.1213/ANE.0000000000002779
  7. Serratus anterior plane block for hybrid transthoracic esophagectomy: a pilot study vol.10, pp.None, 2016, https://doi.org/10.2147/jpr.s121441
  8. Efficacy of Pectoral Nerve Block Type II for Breast-Conserving Surgery and Sentinel Lymph Node Biopsy: A Prospective Randomized Controlled Study vol.2018, pp.None, 2016, https://doi.org/10.1155/2018/4315931
  9. Opioid-sparing effects of the thoracic interfascial plane blocks: A meta-analysis of randomized controlled trials vol.12, pp.1, 2016, https://doi.org/10.4103/sja.sja_382_17
  10. Ultrasound-guided serratus anterior plane block versus thoracic paravertebral block for perioperative analgesia in thoracotomy vol.12, pp.4, 2016, https://doi.org/10.4103/sja.sja_153_18
  11. Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery vol.12, pp.None, 2016, https://doi.org/10.2147/jpr.s191263
  12. Ultrasound-guided continuous serratus anterior plane block: dexmedetomidine as an adjunctive analgesic with levobupivacaine for post-thoracotomy pain. A prospective randomized controlled study vol.12, pp.None, 2016, https://doi.org/10.2147/jpr.s195431
  13. Small dose of naloxone as an adjuvant to bupivacaine in intrapleural infiltration after thoracotomy surgery: a prospective, controlled study vol.32, pp.2, 2019, https://doi.org/10.3344/kjp.2019.32.2.105
  14. Regional Anesthesia in Cardiac Surgery: An Overview of Fascial Plane Chest Wall Blocks vol.131, pp.1, 2020, https://doi.org/10.1213/ane.0000000000004682
  15. Analgesic Effect of Serratus Anterior Plane Block After Thoracoscopic Surgery: A Randomized Controlled Double-Blinded Study vol.16, pp.None, 2016, https://doi.org/10.2147/tcrm.s285244
  16. Comparison of analgesic efficacy of ultrasound-guided thoracic paravertebral block versus surgeon-guided serratus anterior plane block for acute postoperative pain in patients undergoing thoracotomy f vol.14, pp.4, 2016, https://doi.org/10.4103/sja.sja_143_20
  17. The impact of ultrasound‐guided continuous serratus anterior plane block versus intravenous patient‐controlled analgesia on the incidence and severity of post‐thoracotomy pain syn vol.24, pp.1, 2016, https://doi.org/10.1002/ejp.1473
  18. The “Feasibility” And “Safety” Of Ultrasound Guided Bilateral Two Level Serratus Anterior Plane Block in Children With Median Sternotomy Pain: A Case Series vol.35, pp.1, 2016, https://doi.org/10.1053/j.jvca.2020.03.020
  19. Serratus Anterior Block for Long-Term Post-Thoracoscopy Pain Management vol.14, pp.None, 2016, https://doi.org/10.2147/jpr.s295019
  20. Comparison of ultrasonography guided serratus anterior plane block and thoracic paravertebral block in video-assisted thoracoscopic surgery: a prospective randomized double-blind study vol.34, pp.2, 2016, https://doi.org/10.3344/kjp.2021.34.2.234
  21. Serratus Anterior Plane Block and Intercostal Nerve Block after Thoracoscopic Surgery vol.69, pp.6, 2016, https://doi.org/10.1055/s-0040-1705152