Table 2.
Overview of clinical application of serratus anterior plane block in breast surgery
| Study | Sample size | Surgery | SAPB type | Intervention time | Local anesthetics regimen | Control group | Primary outcome |
|---|---|---|---|---|---|---|---|
| Edwards [23] | 64 | Mastectomy | Deep SAPB | Preoperative | 0.35% ropivacaine 30 mL | Superficial SAPB | Less oral morphine equivalents and lower pain scores |
| Mazzinari [27] | 60 | Oncologic breast surgery | Deep SAPB | Preoperative | 0.25% l-bupivacaine 30 mL | No block | Reduced opioid requirement, associated with better pain scores and lower and later rescue analgesia needs in the first 24 h |
| Hards [28] | 27 | Breast surgery | Deep SAPB | Postoperation | 0.375% levobupivacaine (20–30 mL) with 1:200,000 adrenaline and 1 μg/kg of clonidine | Wound infiltration | Pain scores were better |
| Qian [1] | 198 | Modified radical mastectomy | Deep SAPB | Preoperative | 0.5% ropivacaine 30 mL | 0.9% normal saline | Improved acute postoperative analgesia and quality of recovery and decreased the prevalence of CPSP at 3 and 6 months |
| Silva [31] | 30 | Breast surgery | Deep SAPB | Postoperation | 0.2% ropivacaine 15 mL and 80 mg of methylprednisolone | No | SAPB can be an important tool in controlling neuropathic pain |
| Fuzier [36] | 137 | Breast-conserving surgery | Deep SAPB | Preoperative | 0.375% ropivacaine 20 mL | No | Appeared to be protective factors for the risk of pain at 3 months |
| Pérez Herrero [29] | 60 | Non-reconstructive breast surgery | Deep SAPB | Preoperative | 0.2% bupivacaine 20 mL | Thoracic paravertebral block | There were no significant differences |
| Yao [42] | 72 | Breast cancer surgery | Superficial SAPB | Preoperative | 0.5% ropivacaine 25 mL | Physiological saline | Improved the quality of recovery, postoperative analgesia, and patient satisfaction |
| Blanco [2] | 4 | Volunteers | Superficial SAPB | 0.125% levobupivacaine 0.4 mL/kg | Deep SAPB | Appeared to be more effective in terms of anesthesia diffusion, sensory distribution, and duration of action | |
| Kunigo [8] | 88 | Breast cancer surgery | Superficial SAPB | Preoperative | 0.375% ropivacaine 40 mL | 0.375% ropivacaine 20 mL | 20 mL could be sufficient for SAPB analgesia |
| Huang [9] | 60 | Breast surgery | Deep SAPB | Preoperative | 0.5%, ropivacaine 20 mL | 0.375%, 0.75% ropivacaine 20 mL | SAPB with 0.5% ropivacaine is recommended for postoperative analgesia in breast surgery |
| Xiao [5] | 84 | Radical mastectomy | Superficial SAPB + patient controlled SAPB | Preoperative |
0.33% ropivacaine 30 mL |
SAPB + patient-controlled intravenous analgesia (PCIA); PCIA | Reduced pain and adverse events, alleviating anxiety, improving the quality of early postoperative recovery |