• Jungwon Lee and Saeyoung Kim.
• Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine.
• Medicine (Baltimore). 2019 May 1; 98 (18): e15385e15385.

BackgroundThoracotomy is one of the most painful surgeries; therefore, video-assisted thoracoscopic surgery (VATS) was developed to reduce the surgical stress of thoracotomy. Although VATS results in reduced postoperative pain compared with thoracotomy, it is still painful. Serratus plane block (SPB) is a novel technique that provides lateral chest wall analgesia by blocking the lateral branch of the intercostal nerve.MethodsWe conducted a prospective study in 50 patients, aged 20 to 75 years, undergoing three-port VATS lobectomy. Group G (n = 25) received conventional general anesthesia and Group S (n = 25) received SPB before induction of general anesthesia. In Group S, 20 ml of 0.375% ropivacaine was injected between the serratus anterior and latissimus dorsi muscles. During surgery, anesthesia was maintained by adjusting the propofol dose to maintain a bispectral index of 40 to 60 and the remifentanil dose to maintain blood pressure and heart rate within 70 to 130% of baseline.ResultsIntraoperative remifentanil consumption was significantly lower in Group S compared to that in Group G (519.9 μg vs 1047.7 μg, P < .001). Moreover, emergence time was significantly shorter in Group S compared to Group G (10.8 minutes vs 14.9 minutes, P = .01). However, there were no significant differences in systolic blood pressure and heart rate (HR) between the groups at each time point. The doses of rescue drugs for the control of blood pressure and HR were not significantly different between the 2 groups.ConclusionsUltrasound-guided SPB could be a safe and effective regional anesthesia technique for VATS.

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