Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Aug;23(8):295-303.
doi: 10.1016/j.bjae.2023.05.001. Epub 2023 Jun 22.

Regional analgesia for acute pain relief after open thoracotomy and video-assisted thoracoscopic surgery

S Mehta  1 , T T H Jen  2   3 , D L Hamilton  4   5
Affiliations
Review

Regional analgesia for acute pain relief after open thoracotomy and video-assisted thoracoscopic surgery

S Mehta et al. BJA Educ. 2023 Aug.
No abstract available

Keywords: analgesia; nerve block; pain; postoperative; thoracotomy.

PubMed Disclaimer

Conflict of interest statement

DLH is an editor and editorial board member of BJA Education. The other authors declare that they have no conflicts of interest.

Figures

Fig 1
Fig 1
Transverse section through the thorax at the level of the third thoracic vertebra (T3) showing innervation of the thoracic wall and targets for thoracic fascial plane blocks. Muscles: ESM, erector spinae; Ext IM, external intercostal; Inn IM, innermost intercostal; Int IM, internal intercostal; Pec, pectoralis. Regional block targets: ESP, erector spinae plane; MTP, mid-point transverse process to pleura block; RISS, Rhomboid intercostal and subserratus plane; RLB, retrolaminar block; SAP, serratus anterior plane; TPVB, thoracic paravertebral block. Modified from FitzGerald and colleagues (2019).
Fig 2
Fig 2
Sonographic imaging for erector spinae plane block (A and B) and serratus anterior plane block (C and D). ES, erector spinae; IC, intercostal muscles; ITC, intertransverse tissue complex; LD, latissimus dorsi; SA, serratus anterior; Rm; rhomboid major, TP, transverse process, Tr, Trapezius. Dotted line, pleura; dashed line, erector spinae plane (B) and superfical SAP (D). The thoracodorsal artery is shown in red.
Fig 3
Fig 3
Algorithm for regional analgesia options for VATS as outlined by PROSPECT Recommendations for Video-Assisted Thoracoscopic Surgery 2021. VATS, video-assisted thoracoscopic surgery.
Fig 4
Fig 4
Proposed algorithm for regional analgesic options for open thoracotomy. Adapted from PROSPECT Recommendations for Thoracotomy 2015. ICNB, intercostal nerve block; LA, local anaesthetic.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Yeung J.H., Gates S., Naidu B.V., Wilson M.J., Gao Smith F. Paravertebral block versus thoracic epidural for patients undergoing thoracotomy. Cochrane Database Syst Rev. 2016;2:CD009121. - PMC - PubMed
    1. Woodworth G.E., Ivie R.M.J., Nelson S.M., Walker C.M., Maniker R.B. Peri-operative breast analgesia: a qualitative review of anatomy and regional techniques. Reg Anesth Pain Med. 2017;42:609–631. - PubMed
    1. Pintelon I., Brouns I., De Proost I., Van Meir F., Timmermans J.-P., Adriaensen D. Sensory receptors in the visceral pleura. Neurochemical coding and live staining in whole mounts. Am J Respir Cell Mol. 2007;36:541–551. - PubMed
    1. Franco C.D., Inozemtsev K. Refining a great idea: the consolidation of PECS I, PECS II and serratus blocks into a single thoracic fascial plane block, the SAP block. Reg Anesth Pain Med. 2020;45:151–154. - PubMed
    1. Pennefather S.H., McKevith J. In: Principles and Practice of Anesthesia for Thoracic Surgery. Slinger P. (ed), editor. Springer; New York, USA: 2011. Pain Management After Thoracic Surgery.