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. 2025 Apr 1;21(2):162-168.
doi: 10.4103/jmas.jmas_345_23. Epub 2024 Jul 30.

Safety and efficacy of surgically performed continuous superficial serratus anterior plane block in uniportal video-assisted thoracic surgery

Giovanni Punzo  1 , Dania Nachira  2 , Giuseppe Calabrese  2 , Chiara Cambise  1 , Maria Teresa Congedo  2 , Maria Letizia Vita  2 , Elisa Meacci  2 , Stefano Margaritora  2
Affiliations

Safety and efficacy of surgically performed continuous superficial serratus anterior plane block in uniportal video-assisted thoracic surgery

Giovanni Punzo et al. J Minim Access Surg. .

Abstract

Introduction: The 'surgically performed' continuous superficial serratus anterior plane block (continuous s-SAPB) was never described before in uniportal video-assisted thoracic surgery (uniportal VATS) surgery. The aim of the study was to evaluate the safety and efficacy of the technique.

Patients and methods: Between March 2022 and April 2023, 50 patients, undergone uniportal VATS surgery at our thoracic surgery department, were scheduled for a surgically performed continuous s-SAPB as post-operative analgesia protocol.

Results: The mean execution time for the block was 3.92 ± 2.56 min. Ten patients (20%) required morphine for a visual analogue scale (VAS) score >4 immediately after surgery. The recorded VAS score at chest tube removal was 1.87 ± 1.41, whereas 2 h after the manoeuvre was 0.42 ± 0.72. No complication related to block insertion was recorded. The onset of chronic pain was observed in a total of 2 patients (4%).

Conclusions: The surgically performed continuous s-SAPB in uniportal VATS seems to be safe and easy to perform, and it provides a satisfactory analgesic effect.

Keywords: Fascial block; minimally invasive thoracic surgery; pain management; superficial serratus anterior plane block; uniportal video-assisted thoracic surgery.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Main steps of ‘surgically performed continuous superficial serratus anterior plane block. (a) surgical muscle-sparing incision: *Latissimus dorsi muscle, **Serratus anterior muscle, white arrow superficial fascial plane of the serratus muscle. (b) Position of the 18G Tuohy needle through which the catheter is inserted. The blue tip of the catheter is visible (yellow arrow) in transparency behind the superficial fascia of the anterior serratus (**), swelled by previous saline solution injection. (c) Position of the catheter after Tuohy needle removal. (d) Catheter fixation and skin closure
Figure 2
Figure 2
Visual analogue scale score at different time points. VAS: Visual analogue scale
See this image and copyright information in PMC

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