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Efficacy of Ultrasound-Guided Serratus Anterior Plane Block for Postoperative Analgesia in Patients Undergoing Breast Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

OBJECTIVE: Serratus anterior plane block (SAPB) provides effective thoracic analgesia. This systematic review and meta-analysis was conducted to assess the safety and efficacy of SAPB for postoperative analgesia after breast surgery. METHODS: A systematic literature search was performed using Embase...

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Autores principales: Hu, Nian-Qiang, He, Qi-Qi, Qian, Lu, Zhu, Ji-Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560299/
https://www.ncbi.nlm.nih.gov/pubmed/34733377
http://dx.doi.org/10.1155/2021/7849623
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author Hu, Nian-Qiang
He, Qi-Qi
Qian, Lu
Zhu, Ji-Hong
author_facet Hu, Nian-Qiang
He, Qi-Qi
Qian, Lu
Zhu, Ji-Hong
author_sort Hu, Nian-Qiang
collection PubMed
description OBJECTIVE: Serratus anterior plane block (SAPB) provides effective thoracic analgesia. This systematic review and meta-analysis was conducted to assess the safety and efficacy of SAPB for postoperative analgesia after breast surgery. METHODS: A systematic literature search was performed using Embase, PubMed, Web of Science, and the Cochrane Library for eligible randomised controlled trials. The primary outcomes involved the administration of intraoperative and postoperative opioids. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used for rating the quality of evidence for making recommendations. RESULTS: Overall, 13 studies comprising 826 patients met the inclusion criteria (412 in the SAPB group and 414 in the control group). Patients treated with SAPB exhibited a significantly lower postoperative opioid consumption (mean difference, −38.51 mg of oral morphine equivalent; 95% confidence interval (CI), −60.97 to −16.05; P < 0.01; I(2) = 100%), whereas no difference was observed in the intraoperative opioid consumption (mean difference, −9.85 mg of oral morphine equivalent; 95% CI, −19.52 to −0.18; P=0.05; I(2) = 94%). In addition, SAPB significantly decreased the occurrence of postoperative nausea and vomiting (risk ratio, 0.32; 95% CI, 0.19–0.55; P < 0.05;I(2) = 38%) and reduced pain scores during the postoperative period (1 h: standardised mean difference (SMD), −1.23; 95% CI, −2.00 to −0.45; I(2) = 92%; 2 h: SMD, −0.71; 95% CI, −1.00 to −0.41; I(2) = 48%; 4 h: SMD, −1.52; 95% CI, −2.77 to −0.27; I(2) = 95%; 6 h: SMD, −0.80; 95% CI, −1.51 to −0.08; I(2) = 81%; 8 h: SMD, −1.12; 95% CI, −1.98 to −0.27; I(2) = 92%; 12 h: SMD, −0.78; 95% CI, −1.21 to −0.35; I(2) = 83%; and 24 h: SMD, −0.71; 95% CI, −1.20 to −0.23; I(2) = 87%; P < 0.05 for all). CONCLUSION: SAPB was safe and effective after breast surgery to relieve postsurgical pain. However, additional well-developed trials are required to validate these findings.
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spelling pubmed-85602992021-11-02 Efficacy of Ultrasound-Guided Serratus Anterior Plane Block for Postoperative Analgesia in Patients Undergoing Breast Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials Hu, Nian-Qiang He, Qi-Qi Qian, Lu Zhu, Ji-Hong Pain Res Manag Review Article OBJECTIVE: Serratus anterior plane block (SAPB) provides effective thoracic analgesia. This systematic review and meta-analysis was conducted to assess the safety and efficacy of SAPB for postoperative analgesia after breast surgery. METHODS: A systematic literature search was performed using Embase, PubMed, Web of Science, and the Cochrane Library for eligible randomised controlled trials. The primary outcomes involved the administration of intraoperative and postoperative opioids. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used for rating the quality of evidence for making recommendations. RESULTS: Overall, 13 studies comprising 826 patients met the inclusion criteria (412 in the SAPB group and 414 in the control group). Patients treated with SAPB exhibited a significantly lower postoperative opioid consumption (mean difference, −38.51 mg of oral morphine equivalent; 95% confidence interval (CI), −60.97 to −16.05; P < 0.01; I(2) = 100%), whereas no difference was observed in the intraoperative opioid consumption (mean difference, −9.85 mg of oral morphine equivalent; 95% CI, −19.52 to −0.18; P=0.05; I(2) = 94%). In addition, SAPB significantly decreased the occurrence of postoperative nausea and vomiting (risk ratio, 0.32; 95% CI, 0.19–0.55; P < 0.05;I(2) = 38%) and reduced pain scores during the postoperative period (1 h: standardised mean difference (SMD), −1.23; 95% CI, −2.00 to −0.45; I(2) = 92%; 2 h: SMD, −0.71; 95% CI, −1.00 to −0.41; I(2) = 48%; 4 h: SMD, −1.52; 95% CI, −2.77 to −0.27; I(2) = 95%; 6 h: SMD, −0.80; 95% CI, −1.51 to −0.08; I(2) = 81%; 8 h: SMD, −1.12; 95% CI, −1.98 to −0.27; I(2) = 92%; 12 h: SMD, −0.78; 95% CI, −1.21 to −0.35; I(2) = 83%; and 24 h: SMD, −0.71; 95% CI, −1.20 to −0.23; I(2) = 87%; P < 0.05 for all). CONCLUSION: SAPB was safe and effective after breast surgery to relieve postsurgical pain. However, additional well-developed trials are required to validate these findings. Hindawi 2021-10-25 /pmc/articles/PMC8560299/ /pubmed/34733377 http://dx.doi.org/10.1155/2021/7849623 Text en Copyright © 2021 Nian-Qiang Hu et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Hu, Nian-Qiang
He, Qi-Qi
Qian, Lu
Zhu, Ji-Hong
Efficacy of Ultrasound-Guided Serratus Anterior Plane Block for Postoperative Analgesia in Patients Undergoing Breast Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title Efficacy of Ultrasound-Guided Serratus Anterior Plane Block for Postoperative Analgesia in Patients Undergoing Breast Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title_full Efficacy of Ultrasound-Guided Serratus Anterior Plane Block for Postoperative Analgesia in Patients Undergoing Breast Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title_fullStr Efficacy of Ultrasound-Guided Serratus Anterior Plane Block for Postoperative Analgesia in Patients Undergoing Breast Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title_full_unstemmed Efficacy of Ultrasound-Guided Serratus Anterior Plane Block for Postoperative Analgesia in Patients Undergoing Breast Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title_short Efficacy of Ultrasound-Guided Serratus Anterior Plane Block for Postoperative Analgesia in Patients Undergoing Breast Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
title_sort efficacy of ultrasound-guided serratus anterior plane block for postoperative analgesia in patients undergoing breast surgery: a systematic review and meta-analysis of randomised controlled trials
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560299/
https://www.ncbi.nlm.nih.gov/pubmed/34733377
http://dx.doi.org/10.1155/2021/7849623
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