Serratus Anterior Plane Block versus Paravertebral Plane Block for Post Thoracotomy Pain Relief: A Comparative Study

Background: Many analgesic options were suggested for thoracotomy including wound infiltration by local anesthetics, systemic analgesics, regional techniques [such as thoracic paravertebral block (PVB) and serratus anterior plane block (SPB)].Objective: This study aims to compare the efficacy of the SPB and the PVB as a sole analgesic technique after thoracotomy regarding the pain relief, analgesic consumption, hemodynamic stability, and drug related adverse effects.Patients and Methods: This double-blinded, randomized controlled study was done on 60 patients older than 18 years undergoing thoracotomy.Patients were allocated into two equal groups (30 patients each).Group S: Standard anesthesia in addition to SPB.II.Group P: Standard anesthesia in addition to PVB.Results: Visual analogue scale (VAS) at rest and cough was significantly increased in group S than group P at 0, 3, 6, 9, 12, 24, 48 and 72 hours.First time to request morphine was significantly earlier in group S than group P. Total morphine and ketorolac in the 1 st , 2 nd and 3 rd days were significantly increased in group S than group P. Heart rate and mean arterial blood pressure were insignificantly different between both groups at all time measurements.Nausea and vomiting, urinary retention, apnea and ileus were insignificantly different between both groups.Conclusions: Ultrasound guided SPB is an alternative regional block to PVB for thoracotomy but PVB has a more prolonged analgesia with lower VAS and longer analgesic time till 1 st analgesic request, which makes it a useful alternative to the traditional, opioid-based, general anesthetic technique after thoracotomy, but both blocks were equivalent in terms of hemodynamic stability and negative medication side effects.