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Preemptive Analgesic Efficacy of the Ultrasound-Guided Bilateral Superficial Serratus Plane Block on Postoperative Pain in Breast Reduction Surgery: A Prospective Randomized Controlled Study       
Yazarlar
Ali Ahıskalıoğlu
Atatürk Üniversitesi, Türkiye
Ahmet Murat Yayık
Atatürk Üniversitesi, Türkiye
Doç. Dr. Ufuk DEMİR Doç. Dr. Ufuk DEMİR
Kastamonu Üniversitesi, Türkiye
Elif Oral Ahıskalıoğlu
Atatürk Üniversitesi, Türkiye
Erkan Cem Çelik
Atatürk Üniversitesi, Türkiye
Mürsel Ekinci
Türkiye
Mine Çelik
Türkiye
Hakan Çinal
Türkiye
Önder Tan
Türkiye
Muhammed Enes Aydın
Türkiye
Özet
Purpose: Breast surgery is an exceedingly common procedure and associated with an increased incidence of acute and chronic pain. Preemptive regional anesthesia techniques may improve postoperative analgesia for patients undergoing breast surgery. The aim of this study was to evaluate the effect of preoperative bilateral serratus plane block on postoperative opioid consumption in patients undergoing breast reduction surgery. Methods: After ethical board approval, 40 patients undergoing breast reduction surgery were randomized into 2 groups: control group (Group C, n = 20) and serratus plane block group (Group SPB, n = 20). Group C received bilateral ultrasound-guided 2 ml 0.9% saline subcutaneously each block side, Group SPB received ultrasound-guided bilateral SPB with 0.25% bupivacaine 30 ml each side. The groups were administered the routine general anesthesia protocol. All operations were performed with the mediocentral pedicled reduction mammaplasty technique by the same surgeon. Postoperative analgesia was performed intravenously in the 2 groups twice a day with dexketoprofen trometamol 50 mg and patient-controlled analgesia with fentanyl. Postoperative analgesia was evaluated using the visual analog scale (VAS). Fentanyl consumption, additional analgesia requirement and opioid-related side effects were recorded during the first 24 h after surgery. Results: Compared with control, the VAS score was statistically lower in the SPB group during all measurement times (p < 0.05). The 24-h opioid consumption was significantly higher in the control group compared with the SPB group (372.50 ± 39.65 vs. 296.25 ± 58.08 μq, respectively; p < 0.001). In addition, the analgesia requirement was statistically lower in the SPB group (8/20 vs. 2/20, respectively, p < 0.028). Nausea or vomiting was observed more often in the control group than in SPB block (9/20 vs. 2/20, respectively, p = 0.013), whereas other side effects were similar for the two groups. Conclusions: SPB can be used safely bilaterally in the management of pain for breast reduction surgery as it is easy to perform, provides excellent analgesia, and reduces opioid consumption and opioid sparing effect. Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Anahtar Kelimeler
Breast reduction surgery | Pain | Preemptive analgesia | Serratus plane block | Ultrasonography
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale
Dergi Adı AESTHETIC PLASTIC SURGERY
Dergi ISSN 0364-216X
Dergi Tarandığı Indeksler SCI-Expanded
Dergi Grubu Q3
Makale Dili Türkçe
Basım Tarihi 02-2020
Cilt No 44
Sayı 1
Sayfalar 37 / 44
Doi Numarası 10.1007/s00266-019-01542-y
Makale Linki http://dx.doi.org/10.1007/s00266-019-01542-y