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Ultrasound-Guided Pectoserratus Plane Block and Superficial Serratus Anterior Plane Block for Subcutaneous Implantable Cardioverter-Defibrillator Implantation: A Comparative Study.

Authors
  • Szamborski, Marek1
  • Janc, Jarosław1
  • Leśnik, Patrycja1
  • Milnerowicz, Artur2
  • Jagielski, Dariusz3
  • Łysenko, Lidia4
  • 1 Department of Anaesthesiology and Intensive Therapy, 4th Military Clinical Hospital, Wrocław, Poland. , (Poland)
  • 2 Department of Vascular Surgery, 4th Military Clinical Hospital, Wrocław, Poland. , (Poland)
  • 3 Department of Cardiology, Centre for Heart Diseases, 4th Military Clinical Hospital, Wrocław, Poland. , (Poland)
  • 4 Department of Anesthesiology and Intensive Therapy, Wrocław Medical University, Wrocław, Poland. , (Poland)
Type
Published Article
Journal
Medical Science Monitor
Publisher
"International Scientific Information, Inc."
Publication Date
Jul 21, 2023
Volume
29
Identifiers
DOI: 10.12659/MSM.940541
PMID: 37475210
Source
Medline
Language
English
License
Unknown

Abstract

BACKGROUND The combination of pectoserratus plane block (PSP) and superficial serratus anterior plane block (S-SAP) was established to reduce the risk of general anesthesia for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation in patients with high operative risk (American Society of Anesthesiologistsgrade III or IV). This study compared outcomes from ultrasound-guided PSP and S-SAP in 16 patients requiring a subcutaneous implantable cardioverter-defibrillator (S-ICD) at a single center in Poland. MATERIAL AND METHODS A group of 16 patients with ASA grade III and IV qualified for S-ICD implantation was included. The pain assessment using numerical rating scale (NRS), patient's comfort using Quality of Recovery-15 (QoR-15), the operator's satisfaction using Operator's Comfort Scale, adverse event occurrence, and the parameters' stability were evaluated. RESULTS The mean volume of the local anesthetics mixture of PSP block was 19.4 mL; S-SAP was 34.7 mL (mean total volume, 54.1 mL). The mean duration of the block was 21.3 min; the mean time of the S-ICD implantation was 108.4 min. Neither circulatory nor respiratory instability was observed. In 8 patients (50%), non-opioid analgesics were administered intraoperatively; in 11 patients (69%), fentanyl bolus ≤200 μg was administered. The intraoperative NRS score was low (max 2 points); NRS 24 h after the procedure was low (max 4 points). The mean value of QoR-15 was 133.9 points. CONCLUSIONS S-SAP combined with PSP is feasible and safe in providing anesthesia/analgesia during S-ICD implantation and showed good effects in a group of patients with high operative risk (ASA III or IV).

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