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#35637 Serratus plane block for postoperative pain management after minimally invasive heart valve surgery: case series
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  1. Yalçın Güvenli1,
  2. Yagmur Cinar1,
  3. Yücel Karaman1,
  4. Ergin Alaygut1,
  5. Aysegul Kunt2 and
  6. Burcin Abud2
  1. 1Anesthesiology and Reanimation, Tepecik Training and Research Hospital, IZMIR, Turkey
  2. 2Cardiovascular surgery, Tepecik Training and Research Hospital, IZMIR, Turkey

Abstract

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Background and Aims The widespread use of ultrasonography in regional anesthesia in recent years; resulted in identifıcation of new blocks such as serratus plane block (SPB). SPB is a regional analgesic technique that blocks T2-T9 which has an excellent role in postoperative pain management for cardiothoracic surgeries. We performed SPB for postoperative analgesia in 5 patients undergoing minimally invasive heart valve surgery (MIHVS).

Methods After obtaining informed consents, SPB block was performed after induction of general anesthesia and before the surgical incision, using 1,5mg/kg 0.25% bupivacaine. Pain was measured using a visual analogue score (VAS) (0, no pain; 10, worst pain imaginable) in recovery and at 6th, 12th, 18th, and 24th hours. VAS was less than 3 for the 24th hour and patients had no need for additional analgesics for a post-block period of 12 hours.

Results SPB provides prolonged postoperative analgesia in patients undergoing MIHVS. Further randomized controlled trials are needed to enhance the efficacy of the SPB.

Conclusions Thoracic pain is thought to be transmitted via nerves originating from T2 to T9. Blockade of unilateral intercostal nerves can provide sufficient analgesia after MIHVS. Combination of opioids, non-steroidal antiinflammatory agents and regional methods; with different mechanisms of action in postoperative pain management is considered to be more effective for post operative analgesia and minimizes side effects as well as reduces incidence of chronic pain.

  • serratus plane block
  • minimally invasive heart surgery
  • ultrasonography
  • postoperative pain management

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