Comparison of continuous Serratus Anterior Plane Block (cSAPB) with bupivacaine versus single liposomal bupivacaine block in postoperative analgesia after Video-Assisted Thoracoscopic Surgery (VATS): a randomized controlled trial

Abstract Background Video-Assisted Thoracoscopic Surgery (VATS) is a commonly used minimally invasive technique in thoracic surgery. The continuous serratus anterior plane block (cSAPB) involves the placement of a catheter deep in the serratus anterior fascia for the slow and continuous infusion of...

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Main Authors: Mingyue Zhang, Zhuo Zheng, Xianfeng Xie, Yuee Dai, Maosen Zhao, Ke Gao, Shaoxing Liu
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-03249-x
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author Mingyue Zhang
Zhuo Zheng
Xianfeng Xie
Yuee Dai
Maosen Zhao
Ke Gao
Shaoxing Liu
author_facet Mingyue Zhang
Zhuo Zheng
Xianfeng Xie
Yuee Dai
Maosen Zhao
Ke Gao
Shaoxing Liu
author_sort Mingyue Zhang
collection DOAJ
description Abstract Background Video-Assisted Thoracoscopic Surgery (VATS) is a commonly used minimally invasive technique in thoracic surgery. The continuous serratus anterior plane block (cSAPB) involves the placement of a catheter deep in the serratus anterior fascia for the slow and continuous infusion of local anesthetics. Liposomal bupivacaine is a formulation of bupivacaine encapsulated in liposomes, which prolongs the release of the drug. This study compares the impact of cSAPB with bupivacaine and single-shot SAPB with liposomal bupivacaine on postoperative recovery quality and pain control after VATS. Methods This study is a Randomized Controlled Trial. Patients were randomly assigned to two groups: one receiving cSAPB with conventional bupivacaine (cSAPB + CB) (n = 35) and the other receiving SAPB with liposomal bupivacaine (SAPB + LB) (n = 35). The primary outcome measure was the Quality of Recovery (QoR-15) scores at 24 and 48 h post-surgery. Secondary outcomes included: pain intensity assessed using the Visual Analog Scale (VAS) pain scale at rest and during deep breathing at 24 and 48 h postoperatively, postoperative pulmonary function, total opioid consumption during and after surgery, and adverse events. Results QoR-15 scores were significantly elevated in the SAPB + LB group at both 24 and 48 h post-surgery(24 h: p = 0.001; 48 h: p = 0.02). Comparative analysis revealed no statistically significant differences between the SAPB + CB group and the SAPB + LB group in terms of VAS scores for pain at rest at 24 and 48 h (24 h: p = 0.06; 48 h: p = 0.46), or during deep breathing (24 h: p = 0.45; 48 h: p = 0.73). Additionally, there were no significant differences in lung function tests (FEV1/FVC ratio, p = 0.95), total intraoperative opioid consumption (p = 0.76), or total postoperative opioid consumption (p = 0.69). However, the incidence of local complications such as swelling and pain was significantly reduced in the SAPB + LB group (p = 0.03). Conclusions The use of single liposomal bupivacaine serratus anterior plane block provides superior early postoperative recovery quality and reduces the incidence of local complications. Trial registration Chinese Clinical Trial Registry, identifier ChiCTR2100054089, June 28,2024.
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spelling doaj-art-51bc884a9da5464bb6cefbb87f4736bc2025-08-20T03:46:19ZengBMCBMC Anesthesiology1471-22532025-08-0125111010.1186/s12871-025-03249-xComparison of continuous Serratus Anterior Plane Block (cSAPB) with bupivacaine versus single liposomal bupivacaine block in postoperative analgesia after Video-Assisted Thoracoscopic Surgery (VATS): a randomized controlled trialMingyue Zhang0Zhuo Zheng1Xianfeng Xie2Yuee Dai3Maosen Zhao4Ke Gao5Shaoxing Liu6Department of Anesthesiology, Chengdu Second People’s HospitalDepartment of Anesthesiology, Chengdu Second People’s HospitalDepartment of Anesthesiology, Chengdu Second People’s HospitalDepartment of Pain Clinic, School of Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaDepartment of Thoracic Surgery, Chengdu Second People’s HospitalDepartment of Thoracic Surgery, Chengdu Second People’s HospitalDepartment of Anesthesiology, Chengdu Second People’s HospitalAbstract Background Video-Assisted Thoracoscopic Surgery (VATS) is a commonly used minimally invasive technique in thoracic surgery. The continuous serratus anterior plane block (cSAPB) involves the placement of a catheter deep in the serratus anterior fascia for the slow and continuous infusion of local anesthetics. Liposomal bupivacaine is a formulation of bupivacaine encapsulated in liposomes, which prolongs the release of the drug. This study compares the impact of cSAPB with bupivacaine and single-shot SAPB with liposomal bupivacaine on postoperative recovery quality and pain control after VATS. Methods This study is a Randomized Controlled Trial. Patients were randomly assigned to two groups: one receiving cSAPB with conventional bupivacaine (cSAPB + CB) (n = 35) and the other receiving SAPB with liposomal bupivacaine (SAPB + LB) (n = 35). The primary outcome measure was the Quality of Recovery (QoR-15) scores at 24 and 48 h post-surgery. Secondary outcomes included: pain intensity assessed using the Visual Analog Scale (VAS) pain scale at rest and during deep breathing at 24 and 48 h postoperatively, postoperative pulmonary function, total opioid consumption during and after surgery, and adverse events. Results QoR-15 scores were significantly elevated in the SAPB + LB group at both 24 and 48 h post-surgery(24 h: p = 0.001; 48 h: p = 0.02). Comparative analysis revealed no statistically significant differences between the SAPB + CB group and the SAPB + LB group in terms of VAS scores for pain at rest at 24 and 48 h (24 h: p = 0.06; 48 h: p = 0.46), or during deep breathing (24 h: p = 0.45; 48 h: p = 0.73). Additionally, there were no significant differences in lung function tests (FEV1/FVC ratio, p = 0.95), total intraoperative opioid consumption (p = 0.76), or total postoperative opioid consumption (p = 0.69). However, the incidence of local complications such as swelling and pain was significantly reduced in the SAPB + LB group (p = 0.03). Conclusions The use of single liposomal bupivacaine serratus anterior plane block provides superior early postoperative recovery quality and reduces the incidence of local complications. Trial registration Chinese Clinical Trial Registry, identifier ChiCTR2100054089, June 28,2024.https://doi.org/10.1186/s12871-025-03249-xContinuous serratus anterior plane blockLiposomal bupivacaineVideo-assisted thoracoscopic surgeryPain
spellingShingle Mingyue Zhang
Zhuo Zheng
Xianfeng Xie
Yuee Dai
Maosen Zhao
Ke Gao
Shaoxing Liu
Comparison of continuous Serratus Anterior Plane Block (cSAPB) with bupivacaine versus single liposomal bupivacaine block in postoperative analgesia after Video-Assisted Thoracoscopic Surgery (VATS): a randomized controlled trial
BMC Anesthesiology
Continuous serratus anterior plane block
Liposomal bupivacaine
Video-assisted thoracoscopic surgery
Pain
title Comparison of continuous Serratus Anterior Plane Block (cSAPB) with bupivacaine versus single liposomal bupivacaine block in postoperative analgesia after Video-Assisted Thoracoscopic Surgery (VATS): a randomized controlled trial
title_full Comparison of continuous Serratus Anterior Plane Block (cSAPB) with bupivacaine versus single liposomal bupivacaine block in postoperative analgesia after Video-Assisted Thoracoscopic Surgery (VATS): a randomized controlled trial
title_fullStr Comparison of continuous Serratus Anterior Plane Block (cSAPB) with bupivacaine versus single liposomal bupivacaine block in postoperative analgesia after Video-Assisted Thoracoscopic Surgery (VATS): a randomized controlled trial
title_full_unstemmed Comparison of continuous Serratus Anterior Plane Block (cSAPB) with bupivacaine versus single liposomal bupivacaine block in postoperative analgesia after Video-Assisted Thoracoscopic Surgery (VATS): a randomized controlled trial
title_short Comparison of continuous Serratus Anterior Plane Block (cSAPB) with bupivacaine versus single liposomal bupivacaine block in postoperative analgesia after Video-Assisted Thoracoscopic Surgery (VATS): a randomized controlled trial
title_sort comparison of continuous serratus anterior plane block csapb with bupivacaine versus single liposomal bupivacaine block in postoperative analgesia after video assisted thoracoscopic surgery vats a randomized controlled trial
topic Continuous serratus anterior plane block
Liposomal bupivacaine
Video-assisted thoracoscopic surgery
Pain
url https://doi.org/10.1186/s12871-025-03249-x
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