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Serratus anterior plane block in subcutaneous implantable cardioverter defibrillator implantation: A case-control analysis.
- Source :
-
Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2020 Jan; Vol. 31 (1), pp. 144-149. Date of Electronic Publication: 2019 Dec 03. - Publication Year :
- 2020
-
Abstract
- Background: A two-incision technique, in association with inter-muscular positioning of the subcutaneous defibrillator (S-ICD), is now the most frequently adopted implantation approach in Europe. Ultrasound-guided serratus anterior plane block (SAPB) has been proposed to provide anesthesia/analgesia during S-ICD implantation.<br />Objective: We performed a case-control analysis in which a standardized SAPB approach was compared with the typical local anesthesia and sedation approach.<br />Methods: Ninety-one consecutive patients underwent implantation of an S-ICD with the SAPB approach for anesthesia/analgesia at 10 centers. The control group consisted of 55 consecutive patients who underwent S-ICD implantation with a standard local approach.<br />Results: The mean procedure duration was 59 ± 15 minutes in the SAPB group and 76 ± 23 minutes in the control group (P < .001). No operative complications were reported in either group. During the procedure, 79 (87%) patients in the SAPB group and 25 (46%) patients in the control group (P < .001) remained awake. Lower values of pain intensity at the device pocket (P = .005) and the lateral tunneling site (P = .046) were reported in the SAPB group. The difference in static (P = .002) and dynamic (P = .007) pain intensity between the groups persisted at 1 hour, while no differences were observed 6 hours after the end of the procedure.<br />Conclusions: SAPB is feasible and effective in providing anesthesia/analgesia during S-ICD implantation. The procedures were successfully accomplished and no complications occurred in either group. However, SAPB was associated with lower pain levels, enabling the need for sedation to be reduced and more patients to remain awake. Moreover, it resulted in shorter procedure durations.<br /> (© 2019 Wiley Periodicals, Inc.)
- Subjects :
- Adult
Aged
Case-Control Studies
Electric Countershock adverse effects
Female
Humans
Italy
Male
Middle Aged
Operative Time
Pain Measurement
Pain, Postoperative diagnosis
Pain, Postoperative etiology
Prospective Studies
Prosthesis Implantation adverse effects
Registries
Risk Factors
Time Factors
Treatment Outcome
Defibrillators, Implantable
Electric Countershock instrumentation
Muscle, Skeletal innervation
Nerve Block adverse effects
Pain, Postoperative prevention & control
Prosthesis Implantation instrumentation
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8167
- Volume :
- 31
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular electrophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 31778266
- Full Text :
- https://doi.org/10.1111/jce.14293