Analgesic efficacy of continuous serratus anterior plane block versus intercostal nerve block and their combination in VATS lobectomy: results from a prospective randomized trial
BackgroundEffective postoperative pain management following video-assisted thoracoscopic surgery (VATS) lobectomy is essential to optimize recovery and minimize opioid consumption. This study aimed to compare the analgesic efficacy of ultrasound-guided continuous serratus anterior plane block (SAPB)...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1607150/full |
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| author | Hyun Ah Lim Gongmin Rim Kwanyong Hyun Yong Jin Chang Deog Gon Cho |
| author_facet | Hyun Ah Lim Gongmin Rim Kwanyong Hyun Yong Jin Chang Deog Gon Cho |
| author_sort | Hyun Ah Lim |
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| description | BackgroundEffective postoperative pain management following video-assisted thoracoscopic surgery (VATS) lobectomy is essential to optimize recovery and minimize opioid consumption. This study aimed to compare the analgesic efficacy of ultrasound-guided continuous serratus anterior plane block (SAPB), intercostal nerve block (INB), and their combination (SAPB + INB) in patients undergoing VATS lobectomy.MethodsIn this single-center, single-blinded, randomized controlled trial, 90 patients undergoing VATS lobectomy for confirmed or suspected lung cancer were randomly assigned to one of three groups: INB (n = 30), continu.ous SAPB (n = 30), or SAPB + INB (n = 30). The primary outcome was postoperative pain assessed using the visual analog scale (VAS) at 24 h. Secondary outcomes included VAS scores at 1, 3, 6, 12, 48, and 72 h postoperatively, cumulative opioid consumption, length of hospital stay, and postoperative complications.ResultsNo significant differences in VAS scores were observed among the three groups at 24 h postoperatively. All groups maintained acceptable pain levels (VAS < 4) throughout the study. However, opioid consumption was significantly lower in both the SAPB and SAPB + INB groups compared to the INB group at all time points (p < 0.01).ConclusionsContinuous SAPB, INB, and SAPB + INB were all effective for postoperative pain management after VATS lobectomy. However, INB alone was associated with significantly higher opioid use. Given its technical simplicity, prolonged analgesic effect, and opioid-sparing properties, continuous SAPB represents a valuable component of multimodal analgesia in enhanced recovery protocols.
Clinical Trial RegistrationIdentifier KCT0009683. |
| format | Article |
| id | doaj-art-3cad4c4c96bb462096ad55a0397d87f7 |
| institution | DOAJ |
| issn | 2296-875X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Surgery |
| spelling | doaj-art-3cad4c4c96bb462096ad55a0397d87f72025-08-20T03:12:24ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-05-011210.3389/fsurg.2025.16071501607150Analgesic efficacy of continuous serratus anterior plane block versus intercostal nerve block and their combination in VATS lobectomy: results from a prospective randomized trialHyun Ah Lim0Gongmin Rim1Kwanyong Hyun2Yong Jin Chang3Deog Gon Cho4Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea Seoul St. Mary’s Hospital, Seoul, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, The Catholic University of Korea St. Vincent’s Hospital, Suwon, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, The Catholic University of Korea St. Vincent’s Hospital, Suwon, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, The Catholic University of Korea St. Vincent’s Hospital, Suwon, Republic of KoreaBackgroundEffective postoperative pain management following video-assisted thoracoscopic surgery (VATS) lobectomy is essential to optimize recovery and minimize opioid consumption. This study aimed to compare the analgesic efficacy of ultrasound-guided continuous serratus anterior plane block (SAPB), intercostal nerve block (INB), and their combination (SAPB + INB) in patients undergoing VATS lobectomy.MethodsIn this single-center, single-blinded, randomized controlled trial, 90 patients undergoing VATS lobectomy for confirmed or suspected lung cancer were randomly assigned to one of three groups: INB (n = 30), continu.ous SAPB (n = 30), or SAPB + INB (n = 30). The primary outcome was postoperative pain assessed using the visual analog scale (VAS) at 24 h. Secondary outcomes included VAS scores at 1, 3, 6, 12, 48, and 72 h postoperatively, cumulative opioid consumption, length of hospital stay, and postoperative complications.ResultsNo significant differences in VAS scores were observed among the three groups at 24 h postoperatively. All groups maintained acceptable pain levels (VAS < 4) throughout the study. However, opioid consumption was significantly lower in both the SAPB and SAPB + INB groups compared to the INB group at all time points (p < 0.01).ConclusionsContinuous SAPB, INB, and SAPB + INB were all effective for postoperative pain management after VATS lobectomy. However, INB alone was associated with significantly higher opioid use. Given its technical simplicity, prolonged analgesic effect, and opioid-sparing properties, continuous SAPB represents a valuable component of multimodal analgesia in enhanced recovery protocols. Clinical Trial RegistrationIdentifier KCT0009683.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1607150/fullvideo-assisted thoracoscopic surgerylobectomyserratus anterior plane block (SAPB)intercostal nerve block (INB)pain control |
| spellingShingle | Hyun Ah Lim Gongmin Rim Kwanyong Hyun Yong Jin Chang Deog Gon Cho Analgesic efficacy of continuous serratus anterior plane block versus intercostal nerve block and their combination in VATS lobectomy: results from a prospective randomized trial Frontiers in Surgery video-assisted thoracoscopic surgery lobectomy serratus anterior plane block (SAPB) intercostal nerve block (INB) pain control |
| title | Analgesic efficacy of continuous serratus anterior plane block versus intercostal nerve block and their combination in VATS lobectomy: results from a prospective randomized trial |
| title_full | Analgesic efficacy of continuous serratus anterior plane block versus intercostal nerve block and their combination in VATS lobectomy: results from a prospective randomized trial |
| title_fullStr | Analgesic efficacy of continuous serratus anterior plane block versus intercostal nerve block and their combination in VATS lobectomy: results from a prospective randomized trial |
| title_full_unstemmed | Analgesic efficacy of continuous serratus anterior plane block versus intercostal nerve block and their combination in VATS lobectomy: results from a prospective randomized trial |
| title_short | Analgesic efficacy of continuous serratus anterior plane block versus intercostal nerve block and their combination in VATS lobectomy: results from a prospective randomized trial |
| title_sort | analgesic efficacy of continuous serratus anterior plane block versus intercostal nerve block and their combination in vats lobectomy results from a prospective randomized trial |
| topic | video-assisted thoracoscopic surgery lobectomy serratus anterior plane block (SAPB) intercostal nerve block (INB) pain control |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1607150/full |
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