Paravertebral nerve block versus combined serratus anterior plane and intercostal nerve blocks in thoracoscopic lung segment surgery in elderly: a retrospective study

TL;DR

This study compares two nerve block techniques for postoperative pain management in elderly patients undergoing lung surgery.

Contribution

It evaluates the effectiveness of paravertebral nerve block versus a combination of serratus anterior and intercostal nerve blocks in elderly thoracoscopic lung surgery patients.

Findings

Both techniques provided effective postoperative analgesia with statistically significant pain reduction.

The combination block was easier to apply compared to paravertebral nerve block.

Rescue analgesia use differed significantly between the two groups.

Abstract

In order to accelerate the rapid recovery of elderly patients undergoing lung surgery, we tend to use multimodal analgesic protocols. A retrospective analytical study was used to analyse postoperative analgesic regimens suitable for older adults.To compare the efficacy of ultrasound-guided paravertebral nerve block and anterior serratus planar nerve block combined with intercostal nerve block for postoperative analgesia in elderly patients undergoing thoracoscopic segmental lung resection.

Elderly patients undergoing elective thoracoscopic segmental lung resection in our hospital were reviewed and divided into the paravertebral nerve block group (Group T) and the anterior serratus plane nerve block combined with intercostal nerve block group (Group S).

Department of Anaesthesiology, Brain Hospital (Chest Campus), Nanjing Medical University, China.

In both groups, the appropriate nerve block was performed under ultrasound guidance while the patients were lying on their sides after induction of anaesthesia.

The primary outcomes of interest were the Visual Analogue Scale (VAS) scores for pain at rest and motion, assessed at preoperative (T0), 24 h postoperative (T1), 48 h postoperative (T2), and 72 h postoperative (T3) for both groups. Additionally, the number of postoperative self-controlled compressions and the number of rescue analgesia administrations within the first 48 h postoperatively were recorded.The primary endpoints of the study are as follows: The resting and motion VAS scores of the two groups were compared at each time point, and the resting and motion VAS scores of the two groups at T1, T2 and T3 were higher than those at T0, and the differences were statistically significant (P < 0.05),and there was a difference in the number of postoperative remedial analgesia in group T compared with group S (P < 0.05).

Both ultrasound-guided thoracic paravertebral nerve block and anterior serratus plane block combined with intercostal nerve block can provide effective postoperative analgesia for elderly patients undergoing thoracoscopic pulmonary segmentectomy, serving as safe and feasible multimodal analgesia protocols.Compared to paravertebral nerve block, the anterior serratus plane block combined with intercostal nerve block is advantageous due to its relative ease of application.

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