Article description

Summary:

• The study aim was to compare the postoperative analgesic efficacy of ultrasound-guided serratus anterior plane block (SAPB) and thoracic paravertebral block (PVB) in pediatric patients undergoing video-assisted thoracoscopic surgery (VATS)
• This was a single-center, prospective, randomized, comparative, open-label, 2-arm study.
• 70 patients aged 2–10 years undergoing VATS were enrolled. Final analysis included 28 patients in the SAPB group and 29 patients in the PVB group.
• Patients were randomized to receive either an ultrasound-guided SAPB or an ultrasound-guided thoracic PVB; both groups received 0.4 mL/kg of 0.25% bupivacaine.
• The primary outcome demonstrated that median (Q1, Q3) morphine consumption within the first 24 postoperative hours did not differ between the SAPB and PVB groups (0.15 [0.1–0.2] vs 0.1 [0.1–0.2] mg/kg, respectively).
• The time required to perform the block was significantly shorter in the SAPB group than in the PVB group (4.4 ± 0.8 vs. 6.9 ± 1.4 minutes; p < 0.001).
• No differences were observed between SAPB and PVB groups in pain scores or intraoperative fentanyl use.

Conclusions:

• SAPB and PVB provided comparable reductions in intraoperative and postoperative opioid use and pain within the first 24 hours after VATS, with SAPB requiring less time to perform and supporting enhanced recovery after VATS.