Analgesic Efficacy Of Ultrasound-guided Paravertebral Block Versus Serratus Anterior Plane Block After Video-assisted Thoracoscopic Surgery

Objective: Serratus anterior plane block(SAPB)is a safe and easy block which used as an analgesia method after breast surgery or thoracic surgery recently,while thoracic paravertebral block(TPVB)is also popular for providing satisfied analgesia besides thoracic epidural(TE)after thoracic surgery.We aim at comparing the analgesic efficacy of TPVB with SAPB as a component of multimodal analgesia after the video-assisted thoracoscopic surgery(VATS).Method: Forty-six ASAⅠ-Ⅱ and aged among 18-79 years old patients scheduled for video-assisted thoracoscopic surgery were randomly divided into two groups : S group scheduled for SAPB and T group scheduled for TPVB.Patients in group T received the TPVB with 20 ml of0.375% ropivacaine,while received the SAPB with same dosage of ropivacaine in group S after induction.All participants were administered flurbiprofen axetil 100 mg + normal saline 50 ml intravenously once after they wake up(transform into twice a day from next day)and took 2compound codeine phosphate and ibuprofen sustained release tablets orally every 12 hours on schedule after extubation.The data were recorded including the total analgesia dosage during the surgery,the time to extubation after surgery,the numerical rating scale(NRS)at rest and on cough at 1h,4h,8h,12 h,24h after extubation,the consumption dosage ofrescue analgesia during the first 24 h after surgery,adverse events,ICU stay and hospital stay after the surgery.Results: Forty-two patients completed the study.NRS scores were comparable in two groups at each point at rest or on cough after surgery.There were also no statistically differences between the two groups when comparing the intraoperative analgesia consumption dosage,the time to extubation after surgery,rescue analgesia used,ICU stay,hospital stay and adverse events.Conclusion: When used single injection of 0.375% ropivacaine 20 ml,SAPB appeared to be a good alternative of TPVB as a part of multimodal analgesia regimen in controlling VATS pain during the first 24 hours.