Ultrasound-guided deep versus superficial continuous serratus anterior plane block for pain management in patients with multiple rib fractures: A prospective randomized double-blind clinical trial
Background: Efficient analgesia is the cornerstone in multiple rib fractures (MRFs) management. The serratus anterior plane block (SAPB) shows promising outcomes. However, it is still provocative whether the superficial or deep approach is more effective in the SAPB procedure. We hypothesized that t...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Saudi Journal of Anaesthesia |
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| Online Access: | https://journals.lww.com/10.4103/sja.sja_493_24 |
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| author | Mohamed F. Mostafa Mohamed Abdel-Moniem Bakr Mohamed Ismail Seddik Mohammed Mamdouh Mohammed Mahmoud Gamal M.A. Ibrahim Ahmed Talaat Ahmed |
| author_facet | Mohamed F. Mostafa Mohamed Abdel-Moniem Bakr Mohamed Ismail Seddik Mohammed Mamdouh Mohammed Mahmoud Gamal M.A. Ibrahim Ahmed Talaat Ahmed |
| author_sort | Mohamed F. Mostafa |
| collection | DOAJ |
| description | Background:
Efficient analgesia is the cornerstone in multiple rib fractures (MRFs) management. The serratus anterior plane block (SAPB) shows promising outcomes. However, it is still provocative whether the superficial or deep approach is more effective in the SAPB procedure. We hypothesized that the deep approach of ultrasound (US)–guided continuous SAPB could be superior for MRFs pain management.
Methods:
Sixty-two adult patients having unilateral MRFs, were randomized into two groups to receive continuous superficial SAPB (group S, n = 31) or continuous deep SAPB (group D, n = 31). As a primary outcome, we compared pain numeric rating scale (NRS), while total analgesic consumption, incentive spirometer volume (IS-V), lung ultrasound score (LUSS), basal and 24-h serum beta-endorphin (BE) levels, and any adverse events were secondary outcomes.
Results:
There was a significant reduction in NRS in favor of group D when compared to group S at 30 minutes (P = 0.001) until 12 hours (P = 0.029); total analgesic consumption was significantly lower in group D (P = 0.005). A significant increase in the median IS-V in group D compared to group S at 90 minutes (P = 0.02) and 12h postblock (P = 0.004) LUSS was significantly lower in D group at 90 min, 12 h, and 24 h (P = 0.04, 0.001, 0.031). No significant differences as regards serum BE levels. No adverse events were noted.
Conclusion:
Either superficial or deep continuous SAPB can be used safely and effectively in managing pain related to MRFs. Notably, the deep approach offered superior analgesia and improved deep breathing compared to the superficial. |
| format | Article |
| id | doaj-art-e681e52ed9f540028a9db7a3ba9fe662 |
| institution | Kabale University |
| issn | 1658-354X 0975-3125 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj-art-e681e52ed9f540028a9db7a3ba9fe6622025-02-06T07:24:16ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X0975-31252025-01-01191586410.4103/sja.sja_493_24Ultrasound-guided deep versus superficial continuous serratus anterior plane block for pain management in patients with multiple rib fractures: A prospective randomized double-blind clinical trialMohamed F. MostafaMohamed Abdel-Moniem BakrMohamed Ismail SeddikMohammed Mamdouh Mohammed MahmoudGamal M.A. IbrahimAhmed Talaat AhmedBackground: Efficient analgesia is the cornerstone in multiple rib fractures (MRFs) management. The serratus anterior plane block (SAPB) shows promising outcomes. However, it is still provocative whether the superficial or deep approach is more effective in the SAPB procedure. We hypothesized that the deep approach of ultrasound (US)–guided continuous SAPB could be superior for MRFs pain management. Methods: Sixty-two adult patients having unilateral MRFs, were randomized into two groups to receive continuous superficial SAPB (group S, n = 31) or continuous deep SAPB (group D, n = 31). As a primary outcome, we compared pain numeric rating scale (NRS), while total analgesic consumption, incentive spirometer volume (IS-V), lung ultrasound score (LUSS), basal and 24-h serum beta-endorphin (BE) levels, and any adverse events were secondary outcomes. Results: There was a significant reduction in NRS in favor of group D when compared to group S at 30 minutes (P = 0.001) until 12 hours (P = 0.029); total analgesic consumption was significantly lower in group D (P = 0.005). A significant increase in the median IS-V in group D compared to group S at 90 minutes (P = 0.02) and 12h postblock (P = 0.004) LUSS was significantly lower in D group at 90 min, 12 h, and 24 h (P = 0.04, 0.001, 0.031). No significant differences as regards serum BE levels. No adverse events were noted. Conclusion: Either superficial or deep continuous SAPB can be used safely and effectively in managing pain related to MRFs. Notably, the deep approach offered superior analgesia and improved deep breathing compared to the superficial.https://journals.lww.com/10.4103/sja.sja_493_24multiple rib fracturespain managementserratus anterior plane block |
| spellingShingle | Mohamed F. Mostafa Mohamed Abdel-Moniem Bakr Mohamed Ismail Seddik Mohammed Mamdouh Mohammed Mahmoud Gamal M.A. Ibrahim Ahmed Talaat Ahmed Ultrasound-guided deep versus superficial continuous serratus anterior plane block for pain management in patients with multiple rib fractures: A prospective randomized double-blind clinical trial Saudi Journal of Anaesthesia multiple rib fractures pain management serratus anterior plane block |
| title | Ultrasound-guided deep versus superficial continuous serratus anterior plane block for pain management in patients with multiple rib fractures: A prospective randomized double-blind clinical trial |
| title_full | Ultrasound-guided deep versus superficial continuous serratus anterior plane block for pain management in patients with multiple rib fractures: A prospective randomized double-blind clinical trial |
| title_fullStr | Ultrasound-guided deep versus superficial continuous serratus anterior plane block for pain management in patients with multiple rib fractures: A prospective randomized double-blind clinical trial |
| title_full_unstemmed | Ultrasound-guided deep versus superficial continuous serratus anterior plane block for pain management in patients with multiple rib fractures: A prospective randomized double-blind clinical trial |
| title_short | Ultrasound-guided deep versus superficial continuous serratus anterior plane block for pain management in patients with multiple rib fractures: A prospective randomized double-blind clinical trial |
| title_sort | ultrasound guided deep versus superficial continuous serratus anterior plane block for pain management in patients with multiple rib fractures a prospective randomized double blind clinical trial |
| topic | multiple rib fractures pain management serratus anterior plane block |
| url | https://journals.lww.com/10.4103/sja.sja_493_24 |
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