Comparison of combined deep and superficial serratus anterior block with thoracic paravertebral block for postoperative pain in patients undergoing video-assisted thoracoscopic surgery

Resumen

Background/aim: Thoracic paravertebral block (TPVB) is a well-established procedure for the management of postoperative pain in patients undergoing video-assisted thoracic surgery (VATS). In recent years, there have been studies suggesting that fascial plane blocks may be an alternative to TPVB. The objective of this study is to determine the efficacy of combined deep and superficial serratus anterior block (C-SAPB) as an alternative to TPVB in the management of postoperative analgesia in VATS.Materials and methods: The patients were divided into two groups: TPVB and C-SAPB. Both groups were administered the same dose of local anesthetics. Multimodal analgesia was achieved for the groups. The primary outcome measure was Visual analog scale (VAS) pain scores and recorded within the first 48 hours of the postoperative period in each group. Secondary outcomes were analgesic requirement, rescue analgesics, complications rate, and postoperative patient satisfaction.Results: 30 patients with C-SAPB, and 30 patients with TPVB, were analyzed. VAS rest and VAS coughing scores were similar in both groups (p > 0.05). Demographic and side effect conditions, total morphine usage, additional analgesic needs, vital parameters, block procedure time, and patient satisfaction were similar between the groups (p > 0.05). Additionally, although block application times were comparable, the time was slightly shorter in C-SAPB.Conclusion: Similar analgesic efficacy was observed between C-SAPB and TPVB. TPVB maintains its place among the first choices in VATS. The efficacy of C-SAPB is comparable to that of TPVB. While the duration of C-SAPB application is not a significant factor, the brief nature of the procedure and its straightforward administration suggest that it may be an effective method.