High Versus Low Dose Serratus Anterior Plane Block After Minimally Invasive Valve Surgery.

Summary

This study aims to compare the efficacy and quality of pain relief provided by the high-dose serratus anterior plane (SAP) block with the standard SAP block in preventing and treating acute postoperative pain after total endoscopic aortic or mitral valve surgery.

Eligibility

Inclusion Criteria:

* Scheduled for elective aortic valve surgery or elective mitral valve surgery via right anterolateral thoracotomy
* Adult patients (minimally 18 years old)
* Bodyweight \> 50kg
* EuroScore ii \< 3%

Exclusion Criteria:

* Refusal to participate
* Inability to communicate due to language or neurologic barriers
* Inability to control and self-administer opioids with PCIA or to comprehend the NRS pain score due to confusion or learning difficulties
* Chronic use of opioids
* Chronic use of analgesic antidepressants and/or antiepileptics
* Use of prohibited medication which possibly interacts with bupivacaine-epinephrine or opioids (mexiletine, ketoconazole, theophylline, IMAO, Digitalis and cimetidine)
* History of major trauma or surgery to right chest wall
* History of chronic pain at right chest wall
* Allergy to opioids and/or local anesthetics
* Allergy to paracetamol
* Class 3 obesity (BMI 40 or more)
* Pregnancy
* Intraoperative events compromising early postoperative recovery (aortic dissection, systolic anterior motion of the mitral valve, cardiac tamponade, brady-arrhytmias requiring external pacing,...)

Conditions5

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