Analgesic effect of ultrasound-guided anterior serratus muscle block in daytime breast surgery
YUE Longji1, QIU Yufei2, HU Jian2, WANG Jiangang2
1.Department of Anesthesiology, Shanxi Medical University, Taiyuan 030001, China; 2.Department of Anesthesiology,First Hospital of Medical University,Taiyuan 030001,China
Abstract：ObjectiveTo explore the effectiveness and safety of the ultrasound-guided serratus anterior plane block (SAPB) for daytime breast surgery.Methods Ninety patients who underwent breast surgery between December 2018 and February 2019 were randomly and equally divided into group T (TPVB), group S(SAPB), and group C(control). The three groups of patients were monitored for such basic vital signs as heart rate, electrocardiograms, blood pressure and pulse oximetry after entering the ward. The venous pump was loaded with dexmedetomidine 0.25 μg/kg that was pumped in 10 minutes, followed by a constant infusion of 0.05 μg/kg that was suspended 15 minutes before the end of the operation. Patients in group T underwent the surgical paravertebral nerve block, those in group S underwent the serratus anterior plane block, and those in group C underwent local anesthesia around the tumor. The number of times of local anesthetic remedies were used in the three groups was recorded, so were the VAS scores of the three groups at h (T1), 2 h (T2), 4 h (T3), and 6 h (T4) after surgery. The incidence of postoperative adverse reactions in the three groups was recorded,so was the duration of surgery in the nerve block group.Results There was no significant difference in postoperative T1 VAS scores between the three groups. The T2, T3, and T4VAS scores of groups T and S were significantly lower than those of group C (P<0.05). There was no significant difference in T3 and T4 VAS scores between patients in group T and group S. Anesthesia remedies were used significantly less frequently in group T and group S than in group C (P<0.05). There was no significant difference in the number of times anesthesia remedies were used between group T and group S. The rate of postoperative complications (chilling, nausea and vomiting, corresponding regional muscle pain) in group C and S was significantly lower than in group T (P<0.05). There was no significant difference in postoperative complications between group C and group S. Nerve block operation took much less time in group S than in group T (P<0.05).Conclusions The analgesic effect of the serratus anterior muscle block under ultrasound guidance is remarkable, and can be safely used in daytime breast surgery.
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2020, Vol. 31 
