A comparative study between ultrasound guided thoracic paravertebral block vs ultrasound guided serratus anterior muscle block in video-assisted thoracoscopic surgeries

Background & Objective: Video-assisted thoracoscopic (VATS) procedures, are becoming increasingly popular. It is recommended to utilize loco-regional analgesia for reducing post-surgical pain because it encourages early postoperative recovery and provides opioid sparing. Various regional analgesic methods, such as paravertebral, intercostal, and serratus plane blocks, may be utilized to alleviate pain after thoracic surgery. This study compares serratus anterior muscle blocks (SAPB) and thoracic paravertebral blocks (TPVB) in providing postoperative pain alleviation following VATS using ultrasound. Methodology: In this randomized prospective comparative trial, 80 patients scheduled for VATS were allocated at random to one of two equal groups; group A received USG- TPVB, and group B received USG-guided SAPB. The postoperative VAS score, time of rescue analgesia, and postoperative nalbuphine consumption were documented throughout a 24-hour period. We also documented the onset of ambulation and any nerve block consequences. Results: VAS was considerably lower in the TPVB group at 12 and 24 h compared to SABP with P value (< 0.001 & 0.029) respectively; also, patients in the TPVB group took longer to request rescue analgesia (10.77 ± 2.28) vs (6.12 ± 1.43) in SABP group with P < 0.001. Also, TPVB group consumed fewer nalbuphine doses (5.56 ± 1.56) than patients in the SAPB group (9.5 ± 3.49) with P < 0.001. Conclusion: When compared to SAPB block, TBVP block was more successful in lowering postoperative pain scores and lowering the overall 24-h postoperative opioid intake following VATS procedures performed under general anesthesia. Keywords: Serratus anterior muscle block; thoracic paravertebral blocks; Pain control; Video-assisted thoracoscopic procedures; VATS Citation: Hussien RM, Afifi GAS, Elshantory SFE, Mohie AGM, Salem MMH. A comparative study between ultrasound guided thoracic paravertebral block vs ultrasound guided serratus anterior muscle block in video-assisted thoracoscopic surgeries. Anaesth. pain intensive care 2024;28(6):996-1003; DOI: 10.35975/apic.v28i6.2489 Received: June 11, 2024; Revised: August 29, 2024; Accepted: September 28, 2024