Effect Of Perioperative Analgesia On Serratus Anterior Plane Block In Children With Congenital Heart Disease Through Right Subaxillary Approach

Objective: We applied ultrasound-guided serratus anterior plane block in the operations for children with congenital heart disease through right subaxillary approach.During the operations,we explored the role of the method in relieving postoperative pain,reducing the application of opioids in the perioperative period and reducing the complications by observing the application of opioids in the perioperative period,postoperative pain score,and postoperative sedation score.Methods: A total of 68 ASA II～III and aged among 1～5 years old patients scheduled for elective through right subaxillary incision for children with atrial septal defect or ventricular septal defect repair surgery were randomly divided into two groups:intravenous analgesia pump combined with serratus anterior plane block group(S group)and simple intravenous analgesia pump group(N group).Patients in SAPB group underwent serratus anterior plane block with 0.5ml/kg of ropivacaine 0.3 % after induction.Postoperative pain management was the same in both groups with intravenous analgesia pump.Observe and record the dosage of remifentanil and FPAS scores.Record postoperative 1,2,4,8,12,24,48 hours FLACC scores and Ramsay scores,the number of analgesia pump,the dosage of midazolam and the incidence of nausea and vomiting.Results: 1.There were no statistical differences between the two groups regarding sex,age,height,weight,types of surgery,ASA classification(P>0.05).2.The dosage of remifentanil was significantly less in S group than in N group(P<0.05).There were no significant differences between groups in duration of operation,and FPAS scores(P>0.05).3.The level of sedation in Ramsay scores and analgesia in FLACC scores at 1h,2h,3h,4h,8h was significantly lower in S group compared to N group(P<0.05),while there was no statistical significance at 12 h,24h,48 h between the two groups.4.The number of analgesia pump and the dosage of midazolam were significantly less in S group than in N group(P<0.05).The incidence of nausea and vomiting were similar between the two groups,and there were no SAPB-related complications in S group.Conclusion: Ultrasound-guided serratus anterior plane block combined with intravenous analgesia pump can provide satisfactory postoperative analgesia for children of right subaxillary incision with congenital heart disease operation,and reduce effectively the perioperative application of opioids.