Serratus anterior-Plane-Block als Katheterverfahren mit intermittierender Bolusgabe bei Thoraxtrauma: Matched Pair-Analyse
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Abstract
Introduction: Thoracic trauma with rib fractures is associated with high mortality,
primarily due to pain-related pulmonary complications. Epidural anesthesia is considered
the gold standard for pain management but carries certain risks and contraindications.
Thoracic wall blocks, such as the SAPB have become established as simple and safe
alternatives, especially in cardiothoracic surgery. The SAPB is increasingly used for rib
fractures, although its exact mechanism of action in this context is not yet fully
understood. Currently, there is limited data on the opioid-sparing potential of SAPB in
thoracic trauma, and follow-up periods are generally short. The aim of this study was to
investigate the reduction in systemic analgesic requirements and individual pain levels
achieved through SAPB.
Materials and Methods: In this retrospective matched-pair analysis, data from 22
patients who received a superficial SAP-catheter with intermittent bolus administration
of ropivacaine were compared to 46 patients who were treated with systemic analgesic
therapy alone between 2005 and 2021.The primary endpoint was the consumption of
MEQ within the first 72 hours, while the secondary endpoint was pain intensity measured
by NRS scores.
Results: The results show that opioid consumption is significantly lower in the SAPB
group compared to the control group, with an average MEQ reduction of 104.7 over 72
hours. Additionally, the intervention group reported significantly lower NRS scores on all
days, and the therapeutic pain target of NRS < 4 was achieved much less frequently in
patients without the SAP catheter. Furthermore, the consumption of non-opioid
analgetics was also significantly reduced in the SAPB group.
Conclusion: Regional anaesthesia using the superficial SAPB with catheter technique
with intermittent bolus administration led to a significant reduction in systemic analgesic
requirements and significantly lower pain scores compared to conventional systemic
pain therapy. The quality and implementation of systemic pain management for patients
without regional anesthesia should be critically reviewed. Further studies are necessary
to understand why the SAPB was insufficiently effective in some patients.
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Dates
Issued: 0025-11-17
Faculty
FB20:Medizin
Language
de
Keywords
Regionalanästhesie
DFG-subjects
2.22-11 - Anästhesiologie
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Heinen, Rebecca: Serratus anterior-Plane-Block als Katheterverfahren mit intermittierender Bolusgabe bei Thoraxtrauma: Matched Pair-Analyse. : 0025-11-17.
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This item has been published with the following license: In Copyright