title: Ultrasound-Guided Serratus Anterior Plane Block Versus Thoracic Epidural Analgesia for Thoracotomy Pain.
abstract: OBJECTIVE
  Thoracotomy is one of the most painful surgical procedures. The aim of this study was to assess the efficacy and safety of ultrasound-guided serratus anterior plane block (SAPB) compared with thoracic epidural analgesia (TEA) for controlling acute thoracotomy pain.
  
  
  METHODS
  A prospective, randomized, observer-blinded, controlled study.
  
  
  METHODS
  The study was performed as a single-institution study in the National Cancer Institute, Cairo University, Egypt.
  
  
  METHODS
  All participants were cancer patients scheduled for thoracotomy.
  
  
  METHODS
  This study was conducted from February to December 2015. Forty patients scheduled for thoracotomy under general anesthesia were allocated randomly into 1 of 2 groups with 20 patients each. SAPB was performed before extubation with an injection of 30 mL of 0.25% levobupivacaine followed by 5 mL/hour of 0.125% levobupivacaine. In the TEA group, thoracic epidural catheters were inserted preoperatively to be activated before extubation using a lower dose regimen to the SAPB group. Heart rate, mean arterial pressure, and the visual analog pain score (VAS) measurements were recorded for 24 hours. Rescue analgesia using intravenous morphine, 0.1 mL/kg, was administered if the VAS was >3.
  
  
  RESULTS
  Compared with preoperative values, the mean arterial pressure in the SAPB group did not change significantly (p = 0.181), whereas it decreased significantly (p = 0.006) in the TEA group. VAS scores and the total dose of morphine consumed were comparable in the 2 groups.
  
  
  CONCLUSIONS
  SAPB appeared to be a safe and effective alternative for postoperative analgesia after thoracotomy.
authors.affiliation: Department of Anaesthesiology, ICU, and Pain Medicine, National Cancer Institute.
authors.forename: Asmaa Elsayed
authors.initials: AE
authors.lastname: Khalil
authors.affiliation: Department of Anaesthesiology, ICU, and Pain Medicine, National Cancer Institute; Department of Anaesthesiology, ICU, and Pain Medicine Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Nasr Mahmoud
authors.initials: NM
authors.lastname: Abdallah
authors.affiliation: Department of Anaesthesiology, ICU, and Pain Medicine, National Cancer Institute. Electronic address: ghada_pashandy@yahoo.com.
authors.forename: Ghada M
authors.initials: GM
authors.lastname: Bashandy
authors.affiliation: Department of Anaesthesiology, ICU, and Pain Medicine, National Cancer Institute; Department of Anaesthesiology, ICU, and Pain Medicine Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Tarek Abdel-Haleem
authors.initials: TA
authors.lastname: Kaddah
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000768:Anesthesia, General / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000494:pharmacology; D064131:Back Muscles / Q000000981:diagnostic imaging / Q000294:innervation*; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000494:pharmacology; D004334:Drug Administration Schedule; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D016037:Single-Blind Method; D013904:Thoracic Vertebrae; D013908:Thoracotomy / Q000009:adverse effects*; D018084:Ultrasonography, Interventional / Q000379:methods; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D000077554:Levobupivacaine; D002045:Bupivacaine
keywords: acute pain; postoperative pain; serratus anterior plane block; thoracic epidural analgesia; thoracotomy