The Role of an Ultrasound-Guided Block of the Deep Plane of the Serratus Muscle in a Modified ERAS Protocol for Cardiac Surgery

Coppolino, Francesco; Sansone, Pasquale; Passavanti, Maria B.; Pace, Maria C.; Sepolvere, Giuseppe; Aurilio, Caterina

The Role of an Ultrasound-Guided Block of the Deep Plane of the Serratus Muscle in a Modified ERAS Protocol for Cardiac Surgery

Francesco Coppolino^{1, *}, Pasquale Sansone¹, Maria B. Passavanti¹, Maria C. Pace¹, Giuseppe Sepolvere², Caterina Aurilio¹

¹ Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

² Casa di cura “ San Michele” srl, Maddaloni (CE), Italy

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 14
First Page: 49
Last Page: 51
Publisher ID: TOATJ-14-49
DOI: 10.2174/2589645802014010049

Article History:

Received Date: 29/02/2020
Revision Received Date: 30/04/2020
Acceptance Date: 18/05/2020
Electronic publication date: 30/07/2020
Collection year: 2020

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© 2020 Coppolino et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

^* Address correspondence to this author at the Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy; Tel: +390815665180; E-mail: francesco.coppolino1987@gmail.com

To date, the use of multimodal techniques can allow substantial opioid-sparing and can reduce pain by using the local and systemic effects of different types of analgesics. Aims: This case report describes a modified ERAS protocol specific for cardiac surgery with the ultrasound-guided block of the deep plane of the serratus muscle (SAP deep block) in a multimodal opioid-sparing approach. \ Two male patients, aged 62 and 67, undergoing elective mini-invasive off-pump Cardiopulmonary Bypass Grafting (CPB), were treated with an opioid-sparing multimodal anesthesiological approach based on the continuous ultrasound-guided SAP deep block. The continuous ultrasound-guided SAP deep block alone can be used in the case of mini-left thoracotomy off-pump cardiopulmonary bypass grafting implementing a multi-modal opioid-sparing strategy. It seems effective in obtaining good (2 hours) weaning from mechanical ventilation, quick (36 hours) discharge from post-operative intensive care, and good post-operative pain control (NRS < 5) even in elderly and frail patients.

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CASE REPORT

The Role of an Ultrasound-Guided Block of the Deep Plane of the Serratus Muscle in a Modified ERAS Protocol for Cardiac Surgery

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