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Serratus Anterior Plane Block Combined with General Analgesia and Patient-Controlled Serratus Anterior Plane Block in Patients with Breast Cancer: A Randomized Control Trial

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Abstract

Introduction

Anterior serratus muscle plane block is a novel regional block technique for blockade of the sensory plane of the lateral cutaneous branch of the intercostal nerve (T2–T9), which effectively relieves the pain of patients and improves the quality of recovery. This study aimed to observe the early effectiveness and safety of serratus anterior plane block combined with general anesthesia and patient-controlled serratus anterior plane block in early postoperative recovery in breast cancer.

Methods

The study involved a total of 84 patients undergoing radical mastectomy in our hospital. The patients were randomly divided into three groups: the serratus anterior block + general anesthesia + patient-controlled serratus anterior plane block group (PCSAPB group), the serratus anterior block + general anesthesia + patient-controlled intravenous analgesia group (PCIA group), and the general anesthesia + PCIA group (control group), with n = 28 cases in each group.

Results

The visual analogue scale (VAS) scores of the three groups were compared before and after the operation (P < 0.001), and the anxiety visual analogue scale (AVAS) scores after operation were compared among the three groups (P < 0.001). The total number of postoperative analgesic pumps in the PCSAPB group was significantly lower than that in the control group (P < 0.05). The incidence of adverse reactions in the three groups was statistically significant (P < 0.05).

Conclusion

The combination of anterior serratus plane block and general anesthesia and patient-controlled anterior serratus plane block reduced pain and adverse events, alleviating anxiety, improving the quality of early postoperative recovery among patients with breast cancer after modified radical mastectomy.

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References

  1. Ghaleb A, Yallowitz A, Marchenko N. Irradiation induces p53 loss of heterozygosity in breast cancer expressing mutant p53. Commun Biol. 2019;2:436.

    Article  CAS  Google Scholar 

  2. Rontogianni S, Synadaki E, Li B, et al. Proteomic profiling of extracellular vesicles allows for human breast cancer subtyping. Commun Biol. 2019;2:325.

    Article  Google Scholar 

  3. De Cassai A, Bonanno C, Sandei L, et al. PECS II block is associated with lower incidence of chronic pain after breast surgery. Korean J Pain. 2019;32(4):286–91.

    Article  Google Scholar 

  4. Karmakar MK, Samy W, Lee A, et al. Survival analysis of patients with breast cancer undergoing a modified radical mastectomy with or without a thoracic paravertebral block: a 5-year follow-up of a randomized controlled trial. Anticancer Res. 2017;37(10):5813–20.

    PubMed  Google Scholar 

  5. Andersen KG, Kehlet H. Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention. J Pain. 2011;12(7):725–46.

    Article  Google Scholar 

  6. Andreae MH, Andreae DA. Regional anaesthesia to prevent chronic pain after surgery: a cochrane systematic review and meta-analysis. Br J Anaesth. 2013;111(5):711–20.

    Article  CAS  Google Scholar 

  7. Blanco R, Parras T, McDonnell JG, Prats-Galino A. Serratus plane block: a novel ultrasound-guided thoracic wall nerve block. Anaesthesia. 2013;68(11):1107–13.

    Article  CAS  Google Scholar 

  8. Madabushi R, Tewari S, Gautam SK, Agarwal A, Agarwal A. Serratus anterior plane block: a new analgesic technique for post-thoracotomy pain. Pain Physician. 2015;18(3):E421-424.

    PubMed  Google Scholar 

  9. Kunhabdulla NP, Agarwal A, Gaur A, et al. Serratus anterior plane block for multiple rib fractures. Pain Physician. 2014;17(4):E553-555.

    Article  Google Scholar 

  10. Wick EC, Grant MC, Wu CL. Postoperative multimodal analgesia pain management with nonopioid analgesics and techniques: a review. JAMA Surg. 2017;152(7):691–7.

    Article  Google Scholar 

  11. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg. 2017;152(3):292–8.

    Article  Google Scholar 

  12. Xueying Li. Sample size estimation for non-inferiority design-counting index. Chin J Intervent Cardiol. 2016;4:359–61.

    Google Scholar 

  13. Goldney RD. Assessment of suicidal intent by a visual analogue scale. Aust NZ J Psychiatry. 1979;13(2):153–5.

    Article  CAS  Google Scholar 

  14. Rosen HD, Cravero JP. Research on emergence agitation in children. Can J Anaesth. 2013;60(8):822–3.

    Article  Google Scholar 

  15. Onishi E, Murakami M, Nishino R, et al. Analgesic effect of double-level retrolaminar paravertebral block for breast cancer surgery in the early postoperative period: a placebo-controlled, randomized clinical trial. Tohoku J Exp Med. 2018;245(3):179–85.

    Article  CAS  Google Scholar 

  16. Bhoi D, Narasimhan P, Nethaji R, et al. Ultrasound-guided midpoint transverse process to pleura block in breast cancer surgery: a case report. A A Pract. 2019;12(3):73–6.

    Article  Google Scholar 

  17. Blanco R, Parras T, McDonnell JG, et al. Serratus plane block: anovel ultrasound-guided thoracic wall nerve block. Anaesthesia. 2013;68(11):1107–13.

    Article  CAS  Google Scholar 

  18. Mayes J, Davison E, Panahi P, et al. An anatomical evaluation of the serratus anterior plane block. Anaesthesia. 2016;71(9):1064–9.

    Article  CAS  Google Scholar 

  19. Mustonen L, Aho T, Harno H, et al. What makes surgical nerve injury painful? A 4-year to 9-year follow-up of patients with intercostobrachial nerve resection in women treated for breast cancer. Pain. 2019;160(1):246–56.

    Article  Google Scholar 

  20. Royse CF, Newman S, Williams Z, et al. A human volunteer study to identify variability in performance in the cognitive domain of the postoperative quality of recovery scale. Anesthesiology. 2013;119(3):576–81.

    Article  Google Scholar 

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Acknowledgements

We thank the participants of the study.

Funding

No funding or sponsorship was received for this study or publication of this article. The Rapid Service Fee was funded by the authors.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Authors’ Contributions

Ying-Kun Xiao was responsible for the design of the study, writing the first draft of the paper and part of the data analysis; Shou-Zhang She was responsible for clinical data collection and statistical analysis of patients; Li-Xin Xu was responsible for postoperative rehabilitation and functional evaluation of patients; Bin Zheng was responsible for guidance for the project design and article review.

Disclosures

All authors, including Ying-Kun Xiao, Shou-Zhang She, Li-Xin Xu and Bin Zheng, and their immediate families have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

Compliance with Ethics Guidelines

All procedures performed in studies involving human participants were in accordance with the ethical standard of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This study was approved by the ethics committee of the Guangzhou First People’s Hospital (No. K-2020-065-01). All patients and their families voluntarily participated in the study and signed the informed consent form.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Anesthesiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, No.1 Panfu Road, Yuexiu District, Guangzhou, 510180, Guangdong, China

    Ying-Kun Xiao, Shou-Zhang She, Li-Xin Xu & Bin Zheng

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  1. Ying-Kun Xiao
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  2. Shou-Zhang She
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  3. Li-Xin Xu
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Correspondence to Ying-Kun Xiao or Bin Zheng.

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Xiao, YK., She, SZ., Xu, LX. et al. Serratus Anterior Plane Block Combined with General Analgesia and Patient-Controlled Serratus Anterior Plane Block in Patients with Breast Cancer: A Randomized Control Trial. Adv Ther 38, 3444–3454 (2021). https://doi.org/10.1007/s12325-021-01782-y

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  • DOI: https://doi.org/10.1007/s12325-021-01782-y

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