Serratus Plane Block in Breast Cancer Surgery: A Systematic Review and Meta-Analysis.

Area of Science:

• Regional Anesthesia
• Oncology
• Pain Management

Background:

• The efficacy and safety of the serratus plane block (SPB) in breast cancer surgery require further evaluation.
• Existing evidence on SPB's role in breast cancer surgery is limited and inconclusive.

Approach:

• A meta-analysis of 12 randomized controlled trials involving 799 patients was conducted.
• The analysis compared SPB with multimodal analgesia and thoracic paravertebral block (TPVB) for breast cancer surgery.
• Data were pooled using the Hartung-Knapp-Sidik-Jonkman method and a random-effects model.

Key Points:

• SPB significantly alleviated acute postoperative pain compared to multimodal analgesia.
• SPB reduced postoperative analgesic consumption by 28.81mg and intraoperative fentanyl use by -56.46mg.
• SPB increased postoperative anesthesia duration by 243.85 min and decreased postoperative nausea and vomiting (RR -1.07).
• SPB demonstrated comparable outcomes to TPVB without reported adverse effects.

Conclusions:

• The serratus plane block is effective in alleviating acute postoperative pain and reducing nausea and vomiting after breast cancer surgery.
• SPB improves perioperative anesthesia outcomes and may serve as a viable alternative to TPVB.