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P253 Serratus plane block for postoperative pain management after minimally invasive heart valve surgery: case series
  1. Yagmur Karaca1,
  2. Yalçın Güvenli2,
  3. Şeyda Kayhan Ömeroğlu3 and
  4. Yücel Karaman4
  1. 1Anesthesiology and Reanimation, Tepecik Training and Research Hospital, IZMIR, Turkey
  2. 2Anesthesiology and Reanimation, Onep Clinic, ISTANBUL, Turkey
  3. 3Anesthesiology and Reanimation, Dr Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, IZMIR, Turkey
  4. 4Anesthesiology and Reanimation, Izmir Bayraklı State Hospital, IZMIR, Turkey

Abstract

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Background and Aims The widespread use of ultrasonography in regional anesthesia in recent years; resulted in the identification 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 a SPB for postoperative analgesia in 5 patients undergoing minimally invasive heart valve surgery (MIHVS).

Methods SPB block was performed after induction of general anesthesia and before the surgical incision, using 1,5mg/kg 0.25% bupivacaine. The pain was measured using a visual analogue score (VAS) (0, no pain; 10, worst pain imaginable) in recovery and at the 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 needcd 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. A combination of opioids, non-steroidal anti-inflammatory 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 the incidence of chronic pain.

  • serratus plane block
  • minimally invasive heart valve surgery
  • postoperative pain

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