P253 Serratus plane block for postoperative pain management after minimally invasive heart valve surgery: case series

<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted</b>: Not relevant (see information at the bottom of this page) <h3>Background and Aims</h3> The widespread use of ultrasonography in regional anesthesia in recent years; resulted in the identification of new blocks such as serratus plane block (SPB). SPB is a regional analgesic technique that blocks T2-T9 which has an excellent role in postoperative pain management for cardiothoracic surgeries. We performed a SPB for postoperative analgesia in 5 patients undergoing minimally invasive heart valve surgery (MIHVS). <h3>Methods</h3> SPB block was performed after induction of general anesthesia and before the surgical incision, using 1,5mg/kg 0.25% bupivacaine. The pain was measured using a visual analogue score (VAS) (0, no pain; 10, worst pain imaginable) in recovery and at the 6th, 12th, 18th, and 24th hours. VAS was less than 3 for the 24th hour and patients had no need for additional analgesics for a post-block period of 12 hours. <h3>Results</h3> SPB provides prolonged postoperative analgesia in patients undergoing MIHVS. Further randomized controlled trials are needcd to enhance the efficacy of the SPB. <h3>Conclusions</h3> Thoracic pain is thought to be transmitted via nerves originating from T2 to T9. Blockade of unilateral intercostal nerves can provide sufficient analgesia after MIHVS. A combination of opioids, non-steroidal anti-inflammatory agents, and regional methods; with different mechanisms of action in postoperative pain management is considered to be more effective for post­ operative analgesia and minimizes side effects as well as reduces the incidence of chronic pain.