Effect of ultrasound-guided serratus anterior plane block in pediatric patients undergoing pectus bar removal: a retrospective study of selected cases
ObjectiveTo evaluate the effect of ultrasound-guided bilateral serratus anterior plane block (SAPB) in selected pediatric patients undergoing pectus bar removal, focusing on those with anticipated higher pain sensitivity or risk of opioid-related complications.MethodsA retrospective analysis was con...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1600442/full |
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| author | Lianzhe Wu Zenghua Xu Xuemei Zhang Fang Wang |
| author_facet | Lianzhe Wu Zenghua Xu Xuemei Zhang Fang Wang |
| author_sort | Lianzhe Wu |
| collection | DOAJ |
| description | ObjectiveTo evaluate the effect of ultrasound-guided bilateral serratus anterior plane block (SAPB) in selected pediatric patients undergoing pectus bar removal, focusing on those with anticipated higher pain sensitivity or risk of opioid-related complications.MethodsA retrospective analysis was conducted on pediatric patients aged 6–17 years who underwent elective pectus bar removal under general anesthesia between September 2024 and February 2025. Patients were categorized into two groups: those receiving ultrasound-guided bilateral SAPB (Group S, n = 30) based on clinical factors such as pain sensitivity or risk of opioid-related complications, and a control group without SAPB (Group C, n = 46). Pain scores at rest and during coughing were assessed using the Numerical Rating Scale (NRS) immediately after awakening (Aldrete score ≥ 9) and at 1, 3, 6, 12, and 24 hours postoperatively. General patient information, dosages of sufentanil, propofol, and remifentanil, postoperative fentanyl supplementation, surgical duration, anesthesia duration, extubation time, and adverse events such as postoperative nausea and vomiting were recorded.ResultsGroup S exhibited significantly lower incidences of postoperative hypoxemia and lower resting and coughing NRS scores within 6 hours postoperatively compared to Group C (P < 0.008, Bonferroni-corrected). SAPB significantly reduced perioperative opioid use (P < 0.05). No statistically significant differences were observed in postoperative nausea and vomiting, delayed ambulation, or delayed oral intake (P > 0.05).ConclusionIn selected pediatric patients undergoing pectus bar removal, SAPB, as part of a multimodal analgesia regimen, was associated with improved perioperative analgesia, reduced postoperative hypoxemia, and decreased opioid use. While SAPB provides clear benefits in reducing postoperative pain and opioid use, we do not suggest routine implementation in all patients. Instead, its use should be individualized based on patient-specific factors such as pain sensitivity, previous analgesic response, and risk of opioid-related complications. |
| format | Article |
| id | doaj-art-939e0a1c733543b5ad7f48ed8b40029b |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-939e0a1c733543b5ad7f48ed8b40029b2025-08-20T03:58:18ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-08-011310.3389/fped.2025.16004421600442Effect of ultrasound-guided serratus anterior plane block in pediatric patients undergoing pectus bar removal: a retrospective study of selected casesLianzhe Wu0Zenghua Xu1Xuemei Zhang2Fang Wang3Department of Ultrasound, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, ChinaDepartment of Anesthesiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, ChinaDepartment of Anesthesiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, ChinaDepartment of Anesthesiology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, ChinaObjectiveTo evaluate the effect of ultrasound-guided bilateral serratus anterior plane block (SAPB) in selected pediatric patients undergoing pectus bar removal, focusing on those with anticipated higher pain sensitivity or risk of opioid-related complications.MethodsA retrospective analysis was conducted on pediatric patients aged 6–17 years who underwent elective pectus bar removal under general anesthesia between September 2024 and February 2025. Patients were categorized into two groups: those receiving ultrasound-guided bilateral SAPB (Group S, n = 30) based on clinical factors such as pain sensitivity or risk of opioid-related complications, and a control group without SAPB (Group C, n = 46). Pain scores at rest and during coughing were assessed using the Numerical Rating Scale (NRS) immediately after awakening (Aldrete score ≥ 9) and at 1, 3, 6, 12, and 24 hours postoperatively. General patient information, dosages of sufentanil, propofol, and remifentanil, postoperative fentanyl supplementation, surgical duration, anesthesia duration, extubation time, and adverse events such as postoperative nausea and vomiting were recorded.ResultsGroup S exhibited significantly lower incidences of postoperative hypoxemia and lower resting and coughing NRS scores within 6 hours postoperatively compared to Group C (P < 0.008, Bonferroni-corrected). SAPB significantly reduced perioperative opioid use (P < 0.05). No statistically significant differences were observed in postoperative nausea and vomiting, delayed ambulation, or delayed oral intake (P > 0.05).ConclusionIn selected pediatric patients undergoing pectus bar removal, SAPB, as part of a multimodal analgesia regimen, was associated with improved perioperative analgesia, reduced postoperative hypoxemia, and decreased opioid use. While SAPB provides clear benefits in reducing postoperative pain and opioid use, we do not suggest routine implementation in all patients. Instead, its use should be individualized based on patient-specific factors such as pain sensitivity, previous analgesic response, and risk of opioid-related complications.https://www.frontiersin.org/articles/10.3389/fped.2025.1600442/fullserratus anterior plane blockpostoperative analgesiapediatricspectus bar removalretrospective study |
| spellingShingle | Lianzhe Wu Zenghua Xu Xuemei Zhang Fang Wang Effect of ultrasound-guided serratus anterior plane block in pediatric patients undergoing pectus bar removal: a retrospective study of selected cases Frontiers in Pediatrics serratus anterior plane block postoperative analgesia pediatrics pectus bar removal retrospective study |
| title | Effect of ultrasound-guided serratus anterior plane block in pediatric patients undergoing pectus bar removal: a retrospective study of selected cases |
| title_full | Effect of ultrasound-guided serratus anterior plane block in pediatric patients undergoing pectus bar removal: a retrospective study of selected cases |
| title_fullStr | Effect of ultrasound-guided serratus anterior plane block in pediatric patients undergoing pectus bar removal: a retrospective study of selected cases |
| title_full_unstemmed | Effect of ultrasound-guided serratus anterior plane block in pediatric patients undergoing pectus bar removal: a retrospective study of selected cases |
| title_short | Effect of ultrasound-guided serratus anterior plane block in pediatric patients undergoing pectus bar removal: a retrospective study of selected cases |
| title_sort | effect of ultrasound guided serratus anterior plane block in pediatric patients undergoing pectus bar removal a retrospective study of selected cases |
| topic | serratus anterior plane block postoperative analgesia pediatrics pectus bar removal retrospective study |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1600442/full |
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