EFFECTIVENESS OF SERRATUS ANTERIOR PLANE BLOCK IN PATIENTS UNDERGOING THORACIC SURGERY

Abstract

Background: Because thoracic surgery causes excruciating pain and opioid-related adverse effects, postoperative pain management is difficult. By blocking the lateral cutaneous branches of intercostal nerves, ultrasound-guided serratus anterior plane block (SAPB), a potential regional anaesthetic technique, provides analgesia to the anterolateral chest wall. This study assesses how well SAPB works to lower postoperative pain, opioid use, and complications in patients after thoracic surgery. Methods: A randomized controlled experiment was done with 80 patients undergoing thoracoscopic surgery, divided into two groups: SAPB (n=40) who received ultrasound-guided SAPB + general anaesthesia, and control (n=40) who received general anaesthetic only. Pain was measured using the Visual Analog Scale (VAS) at 1, 4, and 8 hours postoperatively. Hemodynamic parameters and confounders such as age, gender, smoking status, BMI, and comorbidities were managed using stratification and suitable statistical testing. Results SAPB significantly reduced VAS pain levels compared to controls across all postoperative time periods (p < 0.05). The block's analgesic impact was proportional to injection volume, with 40 mL producing a wider nerve blockade (T2-T5) than 20 mL (T3-T4). In terms of analgesic efficacy, there were no significant differences between 0.5% and 0.75% ropivacaine concentrations, however both were higher than 0.375%. SAPB also reduced opioid use and the incidence of postoperative nausea and vomiting (PONV). Conclusion: For thoracic surgery patients, ultrasound-guided SAPB is an effective, safe, and opioid-free analgesic approach. Optimizing local anesthetic volume and concentration can increase analgesic efficacy while reducing side effects.