The serratus anterior plane block for analgesia after thoracic surgery: A meta-analysis of randomized controlled trails

BACKGROUND: The serratus anterior plane (SAP) block is a newer method that can be used in patients undergoing thoracic surgeries. The postoperative analgesia efficacy of SAP blocks for thoracic surgery remains controversial. We conduct a meta-analysis to evaluate the analgesia of SAP blocks after thoracic surgery. METHODS: We searched PubMed, Embase, EBSCO, the Cochrane Library, Web of Science, and CNKI for randomized controlled trials (RCTs) regarding the postoperative pain control of a SAP block on thoracic surgery. All of the dates were screened and evaluated by two researchers and meta-analysis was performed using RevMan5.3 software. RESULTS: A total of 8 RCTs involving 542 patients were included. The meta-analysis showed statistically significant differences between the two groups with respect to postoperative pain scores at 2 h (standardized mean difference [Std.MD] = −1.26; 95% confidence interval [CI] = −1.66 to −0.86; P < .0001); 6 h (SMD = −0.50; 95%CI = −0.88 to −0.11; P = .01); 12 h (SMD = −0.63; 95%CI = −1.10 to −0.16; P = .009); 24 h (SMD = −0.99; 95%CI = −1.44 to −0.51; P < .0001); postoperative opioid consumption at 24 h (SMD = −0.83; 95%CI = −1.10 to −0.56; P < .00001); and postoperative nausea and vomiting (PONV) rates (RR = 0.39; 95% CI = 0.21–0.73; P = .003). CONCLUSION: The SAP block can play an important role in the management of pain after thoracic surgery by reducing both pain scores and 24-h postoperative opioids consumption. In addition, there is fewer incidence of PONV in the SAP block group.