{
  "abstract": "Background Video-assisted thoracoscopic surgery (VATS) offers numerous advantages over open surgery; nevertheless, it remains associated with significant postoperative pain. Multiple regional anesthesia techniques have been explored, and the serratus anterior plane block (SAPB) has emerged as a promising option; however, evidence on the use of continuous SAPB infusion for quality of recovery (QoR-40) remains limited. We hypothesized that continuous SAPB infusion, combined with multimodal analgesia, could improve QoR-40 after VATS.Methods In this prospective, double-blind, randomized controlled trial, adults undergoing elective VATS received an infusion of either 0.2% ropivacaine or saline via a SAPB catheter, in addition to standardized multimodal analgesia. The primary outcome was the QoR-40 score on postoperative day (POD) 1. Secondary outcomes included QoR-40 scores on POD 2–4, pain scores, opioid consumption in intravenous morphine milligram equivalents (IV MME), length of hospital stay (LOS), complications, and 30-day readmission.Results A total of 173 patients were analyzed (SAPB: n=88; control: n=85). Median QoR-40 scores on POD 1 were higher in the SAPB group (176 (166–184) vs 172 (159–183); p=0.1036), and remained higher across POD 2 to 4, although not statistically significant. SAPB significantly reduced opioid consumption in recovery (8.0±7.4 vs 10.6±9.3 IV MME; p=0.0388) and on POD 1 (12.73±10.75 vs 16.45±12.17 IV MME; p=0.0349). LOS was also lower but not statistically significant by 0.8 days (2.69±1.76 vs 3.50±4.01; p=0.0872). Pain scores, complications, and 30-day readmissions were similar between groups.Conclusions In this prospective, double-blind, randomized, placebo-controlled trial, continuous SAPB catheter infusion did not improve the primary outcome (QoR-40), and the observed differences in secondary outcomes should be interpreted as exploratory. Larger studies are needed to confirm effects on patient-reported recovery.",
  "authors": [
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "Abhijit Biswas"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "Hamza Zidan"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "Lauren Kolodzey"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "Kamal Kumar"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "Mahesh Nagappa"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "Lee-Anne Fochesato"
    },
    {
      "affiliations": [
        "Division of Thoracic Surgery, Department of Surgery, Schulich school of Medicine and Dentistry, Western Univeristy, London, Ontario, Canada"
      ],
      "name": "Dalilah Fortin"
    },
    {
      "affiliations": [
        "Division of Thoracic Surgery, Department of Surgery, Schulich school of Medicine and Dentistry, Western Univeristy, London, Ontario, Canada"
      ],
      "name": "Richard Inculet"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "Cheng Lin"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "Mohammad Misurati"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "George Nicolaou"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "Julio Cesar Gomez Tamayo"
    },
    {
      "affiliations": [
        "Division of Thoracic Surgery, Department of Surgery, Schulich school of Medicine and Dentistry, Western Univeristy, London, Ontario, Canada"
      ],
      "name": "Mehdi Qiabi"
    },
    {
      "affiliations": [
        "Division of Thoracic Surgery, Department of Surgery, Schulich school of Medicine and Dentistry, Western Univeristy, London, Ontario, Canada"
      ],
      "name": "Rahul Nayak"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"
      ],
      "name": "Curtis John Van Doormaal"
    },
    {
      "affiliations": [
        "Division of Thoracic Surgery, Department of Surgery, Schulich school of Medicine and Dentistry, Western Univeristy, London, Ontario, Canada"
      ],
      "name": "Richard Malthaner"
    }
  ],
  "title": "Impact of continuous serratus plane analgesia on quality of recovery after video-assisted thoracic surgery: a prospective double-blind, randomized, placebo-controlled trial",
  "uid": "695325ff-21e0-5089-a097-83499d4efb26"
}