Thoracotomy is one of the most painful surgical procedures. The aim of this
study is to assess efficacy and safety of ultrasound-guided serratus anterior plane block
(SAPB) compared to thoracic epidural analgesia (TEA) for controlling acute thoracotomy
pain.
Methods: This study is registered after approval by the ethics committee benha university, Egypt. This study was carried out in the period from 2017 to 2019. Forty patients scheduled for thoracotomy under general anesthesia were randomly allocated into one of two groups 20 patients each. Group (SAPB); SAPB was performed before extubation with injection of 30 ml of 0.25% levobupivacaine followed by 5 ml/hr of 0.125% levobupivacaine and Group (TEA); thoracic epidural catheters were inserted preoperatively to be activated before extubation using the same dose regimen. Heart rate, mean arterial pressure and VAS pain score were recorded for 24 hours. Rescue analgesia as morphine IV in a dose of 0.1 ml/kg was adminstered if the VAS score was > 3.
Results: In comparison to preoperative values group (SAPB), MAP didn’t change significantly
(p = 0.181), while it decreased significantly (p = 0.001) in TEA group. VAS scores as well as the total dose of morphine consumed were comparable in the two groups in TEA groups.
Conclusion: Serratus anterior plane block appears to be a safe and effective alternative
for postoperative analgesia after thoracotomy.
Key words: thoracotomy; acute pain; thoracic epidural analgesia; serratus anterior plane; postoperative
pain