Efficacy and safety of the serratus anterior block compared to thoracic epidural analgesia in surgery: Systematic review and meta-analysis.

4区医学 Q4 Medicine Diabetologe Pub Date : 2023-06-01 eCollection Date: 2023-10-01 DOI:10.4103/tcmj.tcmj_36_23

Lusianawati, Christian Julio Suhardi, Christrijogo Sumartono, Citrawati Dyah Kencono Wungu

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Abstract

Objectives: The objective of this study was to compare the efficacy and safety of serratus anterior plane block (SAPB) and thoracic epidural analgesia (TEA) in thoracic region surgery.

Materials and methods: We implemented a systematic search of PubMed, ScienceDirect, SCOPUS, and Web of Science and through gray literature for all randomized controlled trials that compared SAPB, a novel thoracic wall nerve block, and TEA in surgery. The evaluated outcomes included the Visual Analog Scale (VAS), hypotension, and postoperative nausea and vomiting (PONV). Review Manager, version 5.4.1, was implemented for the analysis of statistics.

Results: The pooled analysis included six trials that fulfilled the inclusion criteria. In total 384, surgery had received regional blocks (162 - SAPB and 163 - TEA). VAS did not differ significantly between SAPB and TEA, with a mean difference of 0.71, P = 0.08. PONV incidence did not differ significantly between SAPB and TEA (odds ratio = 0.25, P = 0.07). Hypotension incidence was lower in SAPB compared to TEA (odds ratio = 0.10, P = 0.0001).

Conclusion: SAPB yielded comparable VAS with TEA in pain management of thoracic region surgery. The incidence of hypotension was lower in SAPB than in TEA. No difference in PONV incidence was observed. SAPB can be a viable alternative to TEA in thoracic region surgery.

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手术中前锯肌阻滞与胸椎硬膜外镇痛的疗效和安全性:系统回顾和荟萃分析。

目的:本研究的目的是比较锯肌前平面阻滞(SAPB)和胸椎硬膜外镇痛(TEA)在胸椎手术中的疗效和安全性。材料和方法:我们对PubMed、ScienceDirect、SCOPUS和Web of Science进行了系统检索，并通过灰色文献对所有比较SAPB(一种新型胸壁神经阻滞)和TEA在手术中的随机对照试验进行了检索。评估结果包括视觉模拟评分(VAS)、低血压和术后恶心呕吐(PONV)。Review Manager版本5.4.1是为了统计分析而实现的。结果:合并分析包括6项符合纳入标准的试验。共有384例手术接受了局部阻滞(162例SAPB和163例TEA)。VAS在SAPB和TEA之间无显著差异，平均差异为0.71,P = 0.08。SAPB和TEA的PONV发生率无显著差异(优势比= 0.25,P = 0.07)。与TEA相比，SAPB组低血压发生率较低(优势比= 0.10,P = 0.0001)。结论:SAPB与TEA在胸区手术疼痛管理中的效果相当。SAPB组低血压发生率低于TEA组。PONV发病率无差异。SAPB在胸椎手术中可作为TEA的可行替代方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetologe ENDOCRINOLOGY & METABOLISM-

CiteScore

0.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Der Diabetologe offers up-to-date information for all diabetologists working in practical and clinical environments and scientists who are particularly interested in issues of diabetology. The focus is on current developments regarding prevention, diagnostic approaches, management of complications and current therapy strategies. Comprehensive reviews on a specific topical issue provide evidenced based information on diagnostics and therapy. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.

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