Serratus anterior plane block reduces the prevalence of chronic postsurgical pain after modified radical mastectomy: A randomized controlled trial
To determine whether ultrasound-guided serratus anterior plane block (SAPB) is associated with decreased prevalence of chronic postsurgical pain (CPSP) after modified radical mastectomy. Randomized, double-blind, placebo-controlled study. University hospital. We enrolled 198 patients aged 18–65 year...
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| Veröffentlicht in: | Journal of clinical anesthesia 2021-11, Vol.74, p.110410-110410, Article 110410 |
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| creator | Qian, Bin Huang, Shuo Liao, Xincheng Wu, Junbei Lin, Qin Lin, Ying |
| description | To determine whether ultrasound-guided serratus anterior plane block (SAPB) is associated with decreased prevalence of chronic postsurgical pain (CPSP) after modified radical mastectomy.
Randomized, double-blind, placebo-controlled study.
University hospital.
We enrolled 198 patients aged 18–65 years with American Society of Anesthesiologists physical status I to II, undergoing unilateral modified radical mastectomy.
Patients were randomly allocated to receive SAPB with 30 ml of 0.5% ropivacaine (SAPB group) or 0.9% normal saline (Control group).
The primary outcome was the prevalence of CPSP three months after surgery. Secondary outcomes were area under the curve of the numeric rating scale pain scores over 24 h, postoperative 24-h morphine consumption, quality of recovery, length of post-anesthesia care unit stay, postoperative nausea and vomiting, dizziness, SAPB-related adverse events, the prevalence of CPSP at six months, and pain-related function at three and six months.
Preoperative SAPB with 0.5% ropivacaine reduced the prevalence of CPSP at three postoperative months from 46/89 (51.7%) to 22/90 (25.6%), relative risk (95% confidence interval): 0.47 (0.31–0.72), P |
| doi_str_mv | 10.1016/j.jclinane.2021.110410 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2545997264</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0952818021002506</els_id><sourcerecordid>2580916644</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-3e754803dd7b4dfe170654d726ad5d266503a554285f74bfd9c597359f892a133</originalsourceid><addsrcrecordid>eNqFkc9uFSEUh4nR2Gv1FRoSN27myv-ZcWXTqG3SxIW6Jlw4YxmZYQSmSfsYPrGMt3XhxhWE850fcD6EzijZU0LV23E_2uBnM8OeEUb3lBJByRO0o13LGyFZ_xTtSC9Z09GOnKAXOY-EkFqgz9EJF7SVinc79OsLpGTKmrGZCyQfE15CTcWHEO0PnMCtFjIuN4CXBLcmwGwBxwHbmxRnb_ESc8lr-u6tCXgxfsZmqEF4is4PHhxOxv2pTSYXsCVOd-_weT2dXZz8fQVsnEuKIdRtSd6El-jZYEKGVw_rKfr28cPXi8vm-vOnq4vz68ZypkrDoZWiI9y59iDcALQlSgrXMmWcdEwpSbiRUrBODq04DK63sm-57IeuZ4ZyforeHHOXFH-ukIuefLYQtu_HNWsmhez7micq-vofdIxrmuvrKtWRniolNkodKZtizgkGvSQ_mXSnKdGbNT3qR2t6s6aP1mrj2UP8epjA_W171FSB90cA6jxuPSSdrd9MOJ_qTLWL_n93_Aa4ha2d</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2580916644</pqid></control><display><type>article</type><title>Serratus anterior plane block reduces the prevalence of chronic postsurgical pain after modified radical mastectomy: A randomized controlled trial</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><source>ProQuest Central UK/Ireland</source><creator>Qian, Bin ; Huang, Shuo ; Liao, Xincheng ; Wu, Junbei ; Lin, Qin ; Lin, Ying</creator><creatorcontrib>Qian, Bin ; Huang, Shuo ; Liao, Xincheng ; Wu, Junbei ; Lin, Qin ; Lin, Ying</creatorcontrib><description>To determine whether ultrasound-guided serratus anterior plane block (SAPB) is associated with decreased prevalence of chronic postsurgical pain (CPSP) after modified radical mastectomy.
Randomized, double-blind, placebo-controlled study.
University hospital.
We enrolled 198 patients aged 18–65 years with American Society of Anesthesiologists physical status I to II, undergoing unilateral modified radical mastectomy.
Patients were randomly allocated to receive SAPB with 30 ml of 0.5% ropivacaine (SAPB group) or 0.9% normal saline (Control group).
The primary outcome was the prevalence of CPSP three months after surgery. Secondary outcomes were area under the curve of the numeric rating scale pain scores over 24 h, postoperative 24-h morphine consumption, quality of recovery, length of post-anesthesia care unit stay, postoperative nausea and vomiting, dizziness, SAPB-related adverse events, the prevalence of CPSP at six months, and pain-related function at three and six months.
Preoperative SAPB with 0.5% ropivacaine reduced the prevalence of CPSP at three postoperative months from 46/89 (51.7%) to 22/90 (25.6%), relative risk (95% confidence interval): 0.47 (0.31–0.72), P < 0.001. The prevalence of CPSP was reduced at six months from 37/89 (41.6%) to 17/90 (18.9%), relative risk (95% confidence interval): 0.72 (0.58–0.88), P = 0.001. Moreover, SAPB decreased the area under the curve of the numeric rating scale pain scores over 24 h, shortened the length of post-anesthesia care unit stay, reduced postoperative 24-h morphine consumption and the occurrence of postoperative nausea and vomiting, and improved quality of recovery and patient satisfaction, with P < 0.05 for all. No SAPB-related complications occurred.
Preoperative SAPB with ropivacaine improved acute postoperative analgesia and quality of recovery and decreased the prevalence of CPSP at three and six months after modified radical mastectomy.
•Serratus anterior plane block improved postoperative analgesia after modified radical mastectomy.•Serratus anterior plane block enhanced quality of recovery after modified radical mastectomy.•Serratus anterior plane block decreased the prevalence of chronic postsurgical pain after modified radical mastectomy.</description><identifier>ISSN: 0952-8180</identifier><identifier>EISSN: 1873-4529</identifier><identifier>DOI: 10.1016/j.jclinane.2021.110410</identifier><identifier>PMID: 34175638</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute postoperative pain ; Airway management ; Analgesics ; Anesthesia ; Breast cancer ; Breast cancer surgery ; Breast Neoplasms - surgery ; Cancer surgery ; Chronic postsurgical pain ; Epidural ; Female ; Humans ; Mastectomy ; Mastectomy - adverse effects ; Mastectomy, Modified Radical ; Medical personnel ; Morphine ; Multimodal analgesia ; Pain ; Pain, Postoperative - epidemiology ; Pain, Postoperative - prevention & control ; Patient satisfaction ; Postoperative Nausea and Vomiting - epidemiology ; Postoperative Nausea and Vomiting - prevention & control ; Prevalence ; Questionnaires ; Serratus anterior plane block ; Ultrasonic imaging ; Ultrasound-guided</subject><ispartof>Journal of clinical anesthesia, 2021-11, Vol.74, p.110410-110410, Article 110410</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Nov 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c326t-3e754803dd7b4dfe170654d726ad5d266503a554285f74bfd9c597359f892a133</citedby><cites>FETCH-LOGICAL-c326t-3e754803dd7b4dfe170654d726ad5d266503a554285f74bfd9c597359f892a133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2580916644?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994,64384,64386,64388,72340</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34175638$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Qian, Bin</creatorcontrib><creatorcontrib>Huang, Shuo</creatorcontrib><creatorcontrib>Liao, Xincheng</creatorcontrib><creatorcontrib>Wu, Junbei</creatorcontrib><creatorcontrib>Lin, Qin</creatorcontrib><creatorcontrib>Lin, Ying</creatorcontrib><title>Serratus anterior plane block reduces the prevalence of chronic postsurgical pain after modified radical mastectomy: A randomized controlled trial</title><title>Journal of clinical anesthesia</title><addtitle>J Clin Anesth</addtitle><description>To determine whether ultrasound-guided serratus anterior plane block (SAPB) is associated with decreased prevalence of chronic postsurgical pain (CPSP) after modified radical mastectomy.
Randomized, double-blind, placebo-controlled study.
University hospital.
We enrolled 198 patients aged 18–65 years with American Society of Anesthesiologists physical status I to II, undergoing unilateral modified radical mastectomy.
Patients were randomly allocated to receive SAPB with 30 ml of 0.5% ropivacaine (SAPB group) or 0.9% normal saline (Control group).
The primary outcome was the prevalence of CPSP three months after surgery. Secondary outcomes were area under the curve of the numeric rating scale pain scores over 24 h, postoperative 24-h morphine consumption, quality of recovery, length of post-anesthesia care unit stay, postoperative nausea and vomiting, dizziness, SAPB-related adverse events, the prevalence of CPSP at six months, and pain-related function at three and six months.
Preoperative SAPB with 0.5% ropivacaine reduced the prevalence of CPSP at three postoperative months from 46/89 (51.7%) to 22/90 (25.6%), relative risk (95% confidence interval): 0.47 (0.31–0.72), P < 0.001. The prevalence of CPSP was reduced at six months from 37/89 (41.6%) to 17/90 (18.9%), relative risk (95% confidence interval): 0.72 (0.58–0.88), P = 0.001. Moreover, SAPB decreased the area under the curve of the numeric rating scale pain scores over 24 h, shortened the length of post-anesthesia care unit stay, reduced postoperative 24-h morphine consumption and the occurrence of postoperative nausea and vomiting, and improved quality of recovery and patient satisfaction, with P < 0.05 for all. No SAPB-related complications occurred.
Preoperative SAPB with ropivacaine improved acute postoperative analgesia and quality of recovery and decreased the prevalence of CPSP at three and six months after modified radical mastectomy.
•Serratus anterior plane block improved postoperative analgesia after modified radical mastectomy.•Serratus anterior plane block enhanced quality of recovery after modified radical mastectomy.•Serratus anterior plane block decreased the prevalence of chronic postsurgical pain after modified radical mastectomy.</description><subject>Acute postoperative pain</subject><subject>Airway management</subject><subject>Analgesics</subject><subject>Anesthesia</subject><subject>Breast cancer</subject><subject>Breast cancer surgery</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer surgery</subject><subject>Chronic postsurgical pain</subject><subject>Epidural</subject><subject>Female</subject><subject>Humans</subject><subject>Mastectomy</subject><subject>Mastectomy - adverse effects</subject><subject>Mastectomy, Modified Radical</subject><subject>Medical personnel</subject><subject>Morphine</subject><subject>Multimodal analgesia</subject><subject>Pain</subject><subject>Pain, Postoperative - epidemiology</subject><subject>Pain, Postoperative - prevention & control</subject><subject>Patient satisfaction</subject><subject>Postoperative Nausea and Vomiting - epidemiology</subject><subject>Postoperative Nausea and Vomiting - prevention & control</subject><subject>Prevalence</subject><subject>Questionnaires</subject><subject>Serratus anterior plane block</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound-guided</subject><issn>0952-8180</issn><issn>1873-4529</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc9uFSEUh4nR2Gv1FRoSN27myv-ZcWXTqG3SxIW6Jlw4YxmZYQSmSfsYPrGMt3XhxhWE850fcD6EzijZU0LV23E_2uBnM8OeEUb3lBJByRO0o13LGyFZ_xTtSC9Z09GOnKAXOY-EkFqgz9EJF7SVinc79OsLpGTKmrGZCyQfE15CTcWHEO0PnMCtFjIuN4CXBLcmwGwBxwHbmxRnb_ESc8lr-u6tCXgxfsZmqEF4is4PHhxOxv2pTSYXsCVOd-_weT2dXZz8fQVsnEuKIdRtSd6El-jZYEKGVw_rKfr28cPXi8vm-vOnq4vz68ZypkrDoZWiI9y59iDcALQlSgrXMmWcdEwpSbiRUrBODq04DK63sm-57IeuZ4ZyforeHHOXFH-ukIuefLYQtu_HNWsmhez7micq-vofdIxrmuvrKtWRniolNkodKZtizgkGvSQ_mXSnKdGbNT3qR2t6s6aP1mrj2UP8epjA_W171FSB90cA6jxuPSSdrd9MOJ_qTLWL_n93_Aa4ha2d</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Qian, Bin</creator><creator>Huang, Shuo</creator><creator>Liao, Xincheng</creator><creator>Wu, Junbei</creator><creator>Lin, Qin</creator><creator>Lin, Ying</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>202111</creationdate><title>Serratus anterior plane block reduces the prevalence of chronic postsurgical pain after modified radical mastectomy: A randomized controlled trial</title><author>Qian, Bin ; Huang, Shuo ; Liao, Xincheng ; Wu, Junbei ; Lin, Qin ; Lin, Ying</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-3e754803dd7b4dfe170654d726ad5d266503a554285f74bfd9c597359f892a133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute postoperative pain</topic><topic>Airway management</topic><topic>Analgesics</topic><topic>Anesthesia</topic><topic>Breast cancer</topic><topic>Breast cancer surgery</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer surgery</topic><topic>Chronic postsurgical pain</topic><topic>Epidural</topic><topic>Female</topic><topic>Humans</topic><topic>Mastectomy</topic><topic>Mastectomy - adverse effects</topic><topic>Mastectomy, Modified Radical</topic><topic>Medical personnel</topic><topic>Morphine</topic><topic>Multimodal analgesia</topic><topic>Pain</topic><topic>Pain, Postoperative - epidemiology</topic><topic>Pain, Postoperative - prevention & control</topic><topic>Patient satisfaction</topic><topic>Postoperative Nausea and Vomiting - epidemiology</topic><topic>Postoperative Nausea and Vomiting - prevention & control</topic><topic>Prevalence</topic><topic>Questionnaires</topic><topic>Serratus anterior plane block</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound-guided</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Qian, Bin</creatorcontrib><creatorcontrib>Huang, Shuo</creatorcontrib><creatorcontrib>Liao, Xincheng</creatorcontrib><creatorcontrib>Wu, Junbei</creatorcontrib><creatorcontrib>Lin, Qin</creatorcontrib><creatorcontrib>Lin, Ying</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Qian, Bin</au><au>Huang, Shuo</au><au>Liao, Xincheng</au><au>Wu, Junbei</au><au>Lin, Qin</au><au>Lin, Ying</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serratus anterior plane block reduces the prevalence of chronic postsurgical pain after modified radical mastectomy: A randomized controlled trial</atitle><jtitle>Journal of clinical anesthesia</jtitle><addtitle>J Clin Anesth</addtitle><date>2021-11</date><risdate>2021</risdate><volume>74</volume><spage>110410</spage><epage>110410</epage><pages>110410-110410</pages><artnum>110410</artnum><issn>0952-8180</issn><eissn>1873-4529</eissn><abstract>To determine whether ultrasound-guided serratus anterior plane block (SAPB) is associated with decreased prevalence of chronic postsurgical pain (CPSP) after modified radical mastectomy.
Randomized, double-blind, placebo-controlled study.
University hospital.
We enrolled 198 patients aged 18–65 years with American Society of Anesthesiologists physical status I to II, undergoing unilateral modified radical mastectomy.
Patients were randomly allocated to receive SAPB with 30 ml of 0.5% ropivacaine (SAPB group) or 0.9% normal saline (Control group).
The primary outcome was the prevalence of CPSP three months after surgery. Secondary outcomes were area under the curve of the numeric rating scale pain scores over 24 h, postoperative 24-h morphine consumption, quality of recovery, length of post-anesthesia care unit stay, postoperative nausea and vomiting, dizziness, SAPB-related adverse events, the prevalence of CPSP at six months, and pain-related function at three and six months.
Preoperative SAPB with 0.5% ropivacaine reduced the prevalence of CPSP at three postoperative months from 46/89 (51.7%) to 22/90 (25.6%), relative risk (95% confidence interval): 0.47 (0.31–0.72), P < 0.001. The prevalence of CPSP was reduced at six months from 37/89 (41.6%) to 17/90 (18.9%), relative risk (95% confidence interval): 0.72 (0.58–0.88), P = 0.001. Moreover, SAPB decreased the area under the curve of the numeric rating scale pain scores over 24 h, shortened the length of post-anesthesia care unit stay, reduced postoperative 24-h morphine consumption and the occurrence of postoperative nausea and vomiting, and improved quality of recovery and patient satisfaction, with P < 0.05 for all. No SAPB-related complications occurred.
Preoperative SAPB with ropivacaine improved acute postoperative analgesia and quality of recovery and decreased the prevalence of CPSP at three and six months after modified radical mastectomy.
•Serratus anterior plane block improved postoperative analgesia after modified radical mastectomy.•Serratus anterior plane block enhanced quality of recovery after modified radical mastectomy.•Serratus anterior plane block decreased the prevalence of chronic postsurgical pain after modified radical mastectomy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34175638</pmid><doi>10.1016/j.jclinane.2021.110410</doi><tpages>1</tpages></addata></record> |
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| ispartof | Journal of clinical anesthesia, 2021-11, Vol.74, p.110410-110410, Article 110410 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); ProQuest Central UK/Ireland |
| subjects | Acute postoperative pain Airway management Analgesics Anesthesia Breast cancer Breast cancer surgery Breast Neoplasms - surgery Cancer surgery Chronic postsurgical pain Epidural Female Humans Mastectomy Mastectomy - adverse effects Mastectomy, Modified Radical Medical personnel Morphine Multimodal analgesia Pain Pain, Postoperative - epidemiology Pain, Postoperative - prevention & control Patient satisfaction Postoperative Nausea and Vomiting - epidemiology Postoperative Nausea and Vomiting - prevention & control Prevalence Questionnaires Serratus anterior plane block Ultrasonic imaging Ultrasound-guided |
| title | Serratus anterior plane block reduces the prevalence of chronic postsurgical pain after modified radical mastectomy: A randomized controlled trial |
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