Comparison of Analgesic Level of Ultrasound-guided Paravertebral，Erector Spinae and Serratus Anterior Plane Blocks in Thoracic Surgery

Xiansong LU; Dongyan GUO; Fei QIAO

doi:10.12259/j.issn.2095-610X.S20221226

Volume 43 Issue 12

Dec. 2022

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Xiansong LU, Dongyan GUO, Fei QIAO. Comparison of Analgesic Level of Ultrasound-guided Paravertebral，Erector Spinae and Serratus Anterior Plane Blocks in Thoracic Surgery[J]. Journal of Kunming Medical University, 2022, 43(12): 142-146. doi: 10.12259/j.issn.2095-610X.S20221226

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Comparison of Analgesic Level of Ultrasound-guided Paravertebral，Erector Spinae and Serratus Anterior Plane Blocks in Thoracic Surgery

doi: 10.12259/j.issn.2095-610X.S20221226

Dept. of Anesthesia，The 1st School of Clinical Medicine，Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2022-03-17
Available Online: 2022-11-24
Publish Date: 2022-12-25

Abstract

Abstract

Objective To compare the difference of cutaneous nociceptive block plane of three commonly used nerve blocks （thoracic paravertebral block, erector spinae plane block and serratus anterior plane block） in thoracic surgery, and to identify the optimal nerve block combined with postoperative analgesia for thoracic surgery patients. Methods A total of 75 thoracic patients who underwent thoracoscopic surgery in our hospital were selected and randomly divided into three groups: Thoracic paravertebral nerve block group （T group）, erector spinae plane block group （E group） and serratus anterior plane block group （S group）. Group T: local anesthesia was injected into T7 paravertebral space; Group E: local anesthesia was injected into the fascia layer between the lateral erector spinae muscle and the intercostal muscle of the transverse process of T6 and T7. Group S: local anesthesia was injected into the fascial spaces of the latissimus dorsi and serratus anterior at ribs 6 and 7 in the posterior axillary line. All patients in the three groups were injected with 0.5% ropivacaine hydrochloride （15±3） mL under the guidance of ultrasound to ensure the correct position of the needle tip. After 20 minutes of local anesthetic injection, the anesthetic block effect and plane were measured by needle pricking. Results The block plane of the chest wall （midclavicular line and anterior axillary line） in group T was more extensive than that in group E and group S, the mean values of T group were 12.04 （P < 0.05）, 9.76 （P < 0.05）; while the block range of the thoracic wall （midaxillary line and posterior axillary line） in group S was more extensive, the mean values of S group were 9.8 （P < 0.05）, 10.48 （P < 0.05）. Conclusion For patients undergoing thoracic surgery, especially thoracoscopic surgery, it is more reasonable to use thoracic paravertebral nerve block as an auxiliary method for intraoperative anesthesia and postoperative analgesia. Serratus anterior plane block may be more suitable for breast surgery.
- Thoracic paraspinal nerve block,
- Erector spinae muscle block,
- Serratus anterior muscle block,
- Block plane,
- Thoracic surgery

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References

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