Serratus Anterior Plane Block for Management of Post Thoracotomy Pain (SAPB)

Serratus Anterior Plane Block for Management of Post Thoracotomy Pain and Facilitation of Early Recovery After Pediatric Cardiac Surgery

I believe 1 patient was enrolled. The original PI left the institution and the study was not continued after her departure.

This is a single-center, randomized, prospective study evaluating the effect of serratus anterior plane block performed after induction of anesthesia, but before the start of surgery on postoperative opioid requirements. The hypothesis of the study is that serratus anterior plane blocks are relatively simple to perform, provide good postoperative analgesia, facilitate early tracheal extubation, and reduce the length of hospital stay after pediatric cardiac surgery through a thoracotomy.

This is a single-center, randomized, prospective study evaluating the effect of serratus anterior plane block performed after induction of anesthesia, but before the start of surgery on postoperative opioid requirements. There is already a postoperative protocol for the management of pain in the pediatric cardiac intensive care unit. This protocol will be maintained so all patients will be receiving clinically accepted and standard postoperative pain management. Routine preoperative evaluation will be performed to establish eligibility for study inclusion. All patients will receive anesthesia by a pediatric cardiac anesthesiologist according to the clinical protocol established for these patients. The serratus anterior plane block will be performed by a pediatric anesthesiologist on the acute pain service team who routinely perform pain blocks at this institution. Group 1 will receive an ultra-sound guided serratus anterior block after induction of general anesthesia. Group 2 will not receive a serratus anterior block. Postoperative pain will be managed by a pediatric cardiac intensivist according to a standard pain protocol.

Opioid Use, Post-thoracotomy Pain Syndrome, Local Anaesthetic Agent Overdose, Local Anesthetic Complication, Pain, Postoperative

Post thoractomy pain, Fascial plane blocks, Early recovery after thoractomy, Serratus anterior fascial block

Group1 will receive an ultra-sound guided serratus anterior block after induction of general anesthesia

Serratus anterior block will be performed using an ultrasound guided transducer to inject 2mg/kg of 0.2% ropivacaine

Total Time in hours and minutes of endotracheal intubation from date and time of intubation to the date and time of extubation up to 100 days

From date and time of endotracheal intubation to the date and time of endotracheal extubation up to 100 days

From admission to the Cardiovascular ICU until discharge ready time from the Cardiovascular ICU up to 100 days

Total time of supplemental oxygen usage from date and time of endotracheal extubation and application of supplemental oxygen to date and time of supplemental oxygen discontinuation up to 100 days

Inclusion Criteria: 12 months of age or less Infants undergoing cardiac surgery through a thoracotomy incision Infants having surgery performed by a Pediatric Cardiac Surgeon at Riley Hospital Exclusion Criteria: Infants requiring sternotomy or emergency surgery Allergy to local anesthetics Neonates less that 37 weeks gestation Infants intubated prior to surgery Infection at the site of the Serratus Anterior Plane Block 6. Bleeding diathesis with increased risk of hematoma at the block site 7. Allergy to morphine 8. Active pulmonary infection