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Serratus Anterior Plane Block in Pediatric Patients Undergoing Thoracic Surgeries: A Randomized Controlled Trial

Ahmed Ali Gado1, Ahmed Abdalwahab1, Hassan Ali1

  • 1Anesthesia and Pain Management, Department of Anesthesia, Kasr Alainy Faculty of Medicine, Cairo University, Egypt.

Journal of Cardiothoracic and Vascular Anesthesia
|October 5, 2021
PubMed

Insights

Serratus anterior plane block (SAPB) significantly reduced postoperative fentanyl use and pain scores in pediatric patients undergoing thoracotomies. This regional analgesic technique offers a safe and effective option for managing pain in children.

Area of Science:

  • Pediatric Anesthesiology
  • Regional Anesthesia
  • Pain Management

Background:

  • Thoracotomies in pediatric patients are associated with significant postoperative pain.
  • Effective pain management is crucial for recovery and reducing complications.
  • Regional anesthesia techniques are increasingly explored for pediatric surgical pain.

Purpose of the Study:

  • To evaluate the efficacy and safety of serratus anterior plane block (SAPB) for analgesia in pediatric patients undergoing thoracotomies.
  • To compare postoperative pain outcomes and analgesic requirements between patients receiving SAPB and those who did not.

Main Methods:

  • A double-blinded randomized controlled trial was conducted with 70 pediatric patients (6 months-3 years) undergoing thoracotomies.
  • Patients were randomized into two groups: ultrasound-guided SAPB (n=35) or no SAPB (n=35).
  • Both groups received intraoperative fentanyl infusion; postoperative fentanyl consumption, pain scores (FLACC), and analgesia timing were assessed.

Main Results:

  • The SAPB group (SF) demonstrated significantly lower total postoperative fentanyl administration in the first 24 hours compared to the control group (F) (p<0.001).
  • Significant reductions in postoperative FLACC pain scores, intraoperative fentanyl consumption, and delayed first rescue analgesia were observed in the SF group (p<0.001).
  • No significant complications were reported in either group.

Conclusions:

  • Ultrasound-guided serratus anterior plane block is a safe and effective analgesic technique for pediatric patients undergoing thoracotomies.
  • SAPB offers a valuable regional anesthesia option for improving postoperative pain control in this population.
  • The technique is easy to perform and contributes to reduced opioid requirements.
Abstract

Keywords:
SAPB, SAP blockacute post-thoracotomy painpediatric regional anesthesiaserratus anterior plane block

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