“Continuous” and “one-shot” serratus plane block in uniportal video-assisted thoracic surgery: preliminary results

Gian Maria Ferretti, Edoardo Zanfrini, Luca Pogliani, Dania Nachira, Elizabeth Katherine Anna Triumbari, Amedeo Giuseppe Iaffaldano, Elisabetta Gualtieri, Maria Teresa Congedo, Elisa Meacci, Stefano Margaritora


Background: Post-operative pain management has always been a fundamental topic in thoracic surgery. Common analgesic techniques may have important side effects. Minimally invasive surgery provides reduction of post-operative pain if compared with open thoracic surgery, but it doesn’t solve the issue. The aim of this study was to evaluate the role of “serratus plane block” (SPB) in uniportal video-assisted thoracic surgery (U-VATS) and to compare the effectiveness of “continuous” vs. “one-shot” administration of it.
Methods: Forty-four patients undergoing U-VATS surgery were involved in this study: SPB was performed in 22 patients by using a catheter that was positioned above the serratus to obtain a “continuous” SPB through a local continuous application of the anesthetic for 72 hours after surgery, a “one-shot” SPB in other 22 patients, applying a single dose of the anesthetic drug on the serratus superficial fascia before the end of the surgical time.
Results: There was a statistical significance since the first post-operative day for patients in the continuous SPB (cSPB) group, who had better pain control compared with the “one-shot” SBP (osSBP) group. Patients in the cSPB required less systemic pain therapy administration.
Conclusions: cSPB performed after U-VATS surgery seems to offer patients gain in good level of pain tolerance with no observed side effects.