Effects of a Serratus Anterior Plane Block After Video-Assisted Lung Wedge Resection: A Single-Center, Prospective, and Randomized Controlled Trial

<i>Background and Objectives</i>: Video-assisted thoracoscopic surgery (VATS) is associated with less postoperative pain than traditional open thoracotomy. However, trocar and chest tube placement may damage the intercostal nerves, causing significant discomfort. An ultrasound-guided serratus anterior plane block (SAPB) is a promising mode of pain management; this reduces the need for opioids and the associated side-effects. This study evaluated whether SAPB, compared to intravenous analgesia alone, reduces opioid consumption after thoracoscopic lung wedge resection. <i>Materials and Methods</i>: In total, 22 patients undergoing VATS lung wedge resections were randomized into two groups (SAPB and control): both received intravenous patient-controlled analgesia (PCA), and one group received additional SAPB. The primary outcome was the cumulative intravenous fentanyl consumption at 8 h postoperatively. The visual analog scale (VAS) pain scores and the incidence of postoperative complications were assessed over 48 h post surgery. <i>Results</i>: Fentanyl consumption by 8 h post surgery was significantly lower in the SAPB group than in the control group (183 ± 107 μg vs. 347 ± 202 μg, <i>p</i> = 0.035). Although the VAS scores decreased with time in both groups, the differences were not statistically significant. The SAPB group required fewer opioids by 48 h. No significant between-group differences were observed in postoperative complications, including nausea and vomiting. <i>Conclusions</i>: SAPB effectively reduced opioid consumption after VATS lung wedge resection. SABP may serve as a valuable component of multimodal pain management.