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Serratus anterior a...
Serratus anterior and pectoralis plane blocks for robotically assisted mitral valve repair : a randomised clinical trial
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- Alfirevic, Andrej (author)
- Cleveland Clinic Foundation
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- Marciniak, Donn (author)
- Cleveland Clinic Foundation
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- Duncan, Andra E. (author)
- Cleveland Clinic Foundation
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- Kelava, Marta (author)
- Cleveland Clinic Foundation
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- Yalcin, Esra Kutlu (author)
- Cleveland Clinic Foundation
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- Hamadnalla, Hassan (author)
- Henry Ford Health System
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- Pu, Xuan (author)
- Cleveland Clinic Foundation
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- Sessler, Daniel I. (author)
- Cleveland Clinic Foundation
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- Bauer, Andrew (author)
- Cleveland Clinic Foundation
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- Hargrave, Jennifer (author)
- Cleveland Clinic Foundation
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- Bustamante, Sergio (author)
- Cleveland Clinic Foundation
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- Gillinov, Marc (author)
- Cleveland Clinic Foundation
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- Wierup, Per (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Burns, Daniel J.P. (author)
- Cleveland Clinic Foundation
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- Lam, Louis (author)
- Cleveland Clinic Foundation
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- Turan, Alparslan (author)
- Cleveland Clinic Foundation
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(creator_code:org_t)
- 2023
- 2023
- English 9 s.
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In: British Journal of Anaesthesia. - 0007-0912. ; 130:6, s. 786-794
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Abstract
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- Background: Minimally invasive cardiac surgery provokes substantial pain and therefore analgesic consumption. The effect of fascial plane blocks on analgesic efficacy and overall patient satisfaction remains unclear. We therefore tested the primary hypothesis that fascial plane blocks improve overall benefit analgesia score (OBAS) during the initial 3 days after robotically assisted mitral valve repair. Secondarily, we tested the hypotheses that blocks reduce opioid consumption and improve respiratory mechanics. Methods: Adults scheduled for robotically assisted mitral valve repairs were randomised to combined pectoralis II and serratus anterior plane blocks or to routine analgesia. The blocks were ultrasound-guided and used a mixture of plain and liposomal bupivacaine. OBAS was measured daily on postoperative Days 1–3 and were analysed with linear mixed effects modelling. Opioid consumption was assessed with a simple linear regression model and respiratory mechanics with a linear mixed model. Results: As planned, we enrolled 194 patients, with 98 assigned to blocks and 96 to routine analgesic management. There was neither time-by-treatment interaction (P=0.67) nor treatment effect on total OBAS over postoperative Days 1–3 with a median difference of 0.08 (95% confidence interval [CI]: –0.50 to 0.67; P=0.69) and an estimated ratio of geometric means of 0.98 (95% CI: 0.85–1.13; P=0.75). There was no evidence of a treatment effect on cumulative opioid consumption or respiratory mechanics. Average pain scores on each postoperative day were similarly low in both groups. Conclusions: Serratus anterior and pectoralis plane blocks did not improve postoperative analgesia, cumulative opioid consumption, or respiratory mechanics during the initial 3 days after robotically assisted mitral valve repair. Clinical trial registration: NCT03743194.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- analgesia
- cardiac anaesthesia
- fascial muscle plane blocks
- minimally invasive cardiac surgery
- mitral valve repair
- pain
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Alfirevic, Andre ...
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Marciniak, Donn
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Duncan, Andra E.
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Kelava, Marta
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Yalcin, Esra Kut ...
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Hamadnalla, Hass ...
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show more...
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Pu, Xuan
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Sessler, Daniel ...
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Bauer, Andrew
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Hargrave, Jennif ...
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Bustamante, Serg ...
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Gillinov, Marc
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Wierup, Per
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Burns, Daniel J. ...
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Lam, Louis
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Turan, Alparslan
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
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British Journal ...
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Lund University