The Role of an Ultrasound-Guided Block of the Deep Plane of the Serratus Muscle in a Modified ERAS Protocol for Cardiac Surgery
Francesco Coppolino1, *, Pasquale Sansone1, Maria B. Passavanti1, Maria C. Pace1, Giuseppe Sepolvere2, Caterina Aurilio1
Identifiers and Pagination:Year: 2020
First Page: 49
Last Page: 51
Publisher Id: TOATJ-14-49
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
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.
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.