Comparison of intraoperative and postoperative effects of serratus anterior plane block performed with ultrasound and infiltration block in patients undergoing video assisted thoracoscopic surgery (VATS)

In our study, we aimed to compare the intraoperative and postoperative analgesic activities of the preventive applied serratus anterior plan (SAP) block and infiltration block in patients undergoing video-assisted thoracoscopic surgery (VATS) with a prospective and randomized control. The study was carried out in 60 patients in the 18-80 age group, who were eligible to apply elective VATS, with the American Society of Anesthesiologists (ASA) classification 1-2, following ethical committee approval and written consent from patients. Patients were divided into two groups as SAP (Group SAPB) and infiltration block (Group IB) after routine monitoring and general anesthesia induction by recording demographic data after randomization. Hemodynamic data of all patients were recorded before, after induction and intraoperative 30 minutes periods. Patient controlled analgesia (PCA) prepared with morphine was applied to all patients postoperatively. Intraoperative hemodynamic data and opioid consumption of patients, resting time and coughing Visual Analog Scales (VAS), time to first PCA dose, postoperative opioid consumption, salvage analgesic requirement, mobilization times, opioid side effects, patient and surgical team's satisfaction were evaluated. Intraoperative hemodynamic data and opioid consumption were similar between the two groups. Postoperative pain scores (0 and 30 min, 1, 2, 4, 8 and 12 h) were lower in the SAPB group (p<0.005) and longer time to use the first HKA (p=0.002). Postoperative PCA and salvage analgesic requirement were lower in the SAPB group (p=0.002, p=0.00). It was found that the first mobilization time was shorter in the SAPB group (p=0.003), and opioid-related side effects were similar in both groups (p=0.067). Patient and surgical team satisfaction was high in the SAPB group (p=0.004, p = 0.000). As a result, it was concluded that more effective postoperative analgesia was provided with preventively SAP block compared to infiltration block in patients undergoing VATS.