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Minerva Anestesiologica 2020 Dec 15

DOI: 10.23736/S0375-9393.20.14882-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Serratus- intercostal interfascial plane block in supraumbilical surgery: a prospective randomized comparison

María T. FERNÁNDEZ 1 , Servando LÓPEZ 2, Jose A. AGUIRRE 3, Judith ANDRÉS 4, Esperanza ORTIGOSA 5

1 Department of Anesthesiology of Medina del Campo Hospital, Valladolid, Spain; 2 Department of Anesthesiology of Abente y Lago Hospital, A Coruña, Spain; 3 Department of Anesthesiology, Intensive Care and Pain Medicine, Balgrist University Hospital, Zürich, Switzerland; 4 Department of Anesthesiology of Rio Hortega University Hospital, Valladolid, Spain; 5 Department of Anesthesiology of Getafe hospital, Madrid, Spain


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BACKGROUND: Upper abdominal wall surgical incisions may lead to a severe postoperative pain. Adequate analgesia is therefore important. Here we investigate whether the low serratus-intercostal interfascial plane block (SIPB) achieves an effective analgesia, considering opioids consumption, pain control and recovery quality in upper abdominal surgeries.
METHODS: This blinded, randomized controlled study was conducted on 102 patients undergoing open upper abdominal wall surgery under general anesthesia. All patients who received serratus-intercostal plane block at the eighth rib as analgesic technique were included in group SIPB and in Group control those who received continuous intravenous morphine analgesia. Pain scores in numeric verbal scale (NVS) and opioids consumption at 0,6,12,24 y 48h postoperatively were assessed. The quality of the postoperative recovery was evaluated using the QoR-15 questionnaire at 24h.
RESULTS: This study showed lower postoperative opioid consumption at 24h (p < 0.0001; 4,17 mg vs 41,52 mg of morphine) and better pain control (p<0.005) with mean pain scores (NVS 1,8+1.5 vs 4.8+1.6) in group 0 (SIPB). The global QoR-15 scores 24 h postoperatively were higher (better quality) in the SIPB group (122 vs 100).
CONCLUSIONS: The low serratus-intercostal interfascial plane block (SIPB) provides efficient analgesia leading to a saving of opioids and improvement of the recovery quality in patients undergoing upper abdominal wall surgeries.


KEY WORDS: Abdominal surgery; Intercostal nerves; Opioid; Postoperative pain; Ultrasound-guided Serratus-intercostal fascial block

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