Background & Aims

To determine a significant reduction of postoperative pain in patients with thoracotomy using peripheral seratus anterior block and compared to standard postoperative analgesia, detrmine a reduction in use of opioids (as a “rescue” analgesic) in the prevention of postoperative pain, determine that SAPB leads to a reduction in side effects of pain therapy as well as an effect on early patient mobilization.

Methods

The prospective study included 40 patients, divided into two groups, the study and the control. The study group consisted of patients who received serratus plane block, and the control group consisted of those patients who received standard postoperative analgesia.Patients were interviewed for the first 30 minutes after admission to the intensive care unit and then for 1, 3, 6, 12, 24, 48 and 72 hours after surgery, and also on discharge. Preoperative pain intensity was also noted to provide a more accurate basis for assessing postoperative pain. All postoperative side effects of anesthesia and surgery (nausea, constipation, vomiting, etc.) that occurred within the first 24 hours after surgery were noted. The intensity of pain in both groups was compared every 20 min in the first hour, then for 30 minutes in the next two hours and then for 2 hours in the next 12 hours and then for 3 hours in the next 24 h. measured at the indicated time intervals postoperatively.

Results

After the first 60 minutes, there is a statistically significant difference in NRS values between the examined groups (Mann-Whitney test: p = 0.021). After 60 minutes, ie after 1h30min, 2x, 2x and 30min, and 3h between the examined groups, there is a statistically significant difference in the values of the NRS score (Mann-Whitney test: p <0.001, for all measurements).The intensity of pain in patients treated with SAP block showed that the values of NRS after three hours were statistically significantly lower compared to all control measurements, group with block (p <0.05), or control group (p <0, 05). Following the postoperative period of the patient in both groups, ie. On day zero, it was found that the NRS score was statistically significantly lower in the group with the block compared to the control group in the period from 3 - 9h (p <0.001, p = 0.001, p = 0.012), as well as at the end of the period 13-15h ( p = 0.048) Mann-Whitney test, 2 ANOVA for repeated measurements.

Conclusions

Block group patients had a lower pain threshold after thoracic surgery compared with patients who had a standard protocol for the treatment of postoperative pain. The total dose of morphine required to relieve pain after thoracic surgery is bile and bile are significantly lower in patients receiving SAP block than in patients receiving primary standard pain control therapy. SAPB block was not associated with any complications in this study. It should be noted that there were no statistically significant differences in hemodynamic and respiratory parameters between patients receiving SAP block and those receiving standard pain control therapy.

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Presenting Author

Milos Milojkovic

Poster Authors

Milos Milojkovic

surgeon, subspecialist

Clinical Center Nis

Lead Author

stankovic milos

Clinical ceneter Nis

Lead Author

ilic Bojan

Clinical center Nis

Lead Author

Milorad Pavlovic

clinical cenetr Nis

Lead Author

Aneta Jovanovic

clinical center nis

Lead Author

Nikola Vasilijic

KBC Dragisa Misovic Beograd

Lead Author

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Post-surgical/Post-traumatic Chronic Pain