Serratus Anterior Plane Block for Analgesia in Mastectomy

Abstract

The incidence of breast cancer in women is on the rise, but the survival rate has increased due to the progress of medicine, especially if the disease is detected early. One of the imperatives is the patient’s quality of life after treatment. Inadequately treated acute postoperative pain leads to a worse treatment outcome and the development of chronic pain. The incidence of chronic pain after surgical treatment of breast cancer is high and negatively affects the quality of life of patients in the long term. Serratus anterior plane block (SAPB) is a relatively new ultrasound-guided regional analgesia technique. SAPB represents an alternative to an epidural, and to paravertebral and intercostal blocks. This review aims to describe serratus anterior plane block for breast surgery and emphasize their short- and long-term benefit. For this review, we searched MEDLINE in November 2022 to identify metanalyses, randomized controlled trial systemic reviews, and reviews published in the last five years. The search for metanalyses yielded 4 results; 12 results were found for randomized controlled trials; 5 results for reviews; and 4 results for systematic reviews. When employing SAPB in patients after mastectomy, good analgesia is achieved in the early postoperative period and the incidence of chronic pain is reduced, thus improving quality of life.

Keywords

• mastectomy
• ultrasound-guided
• serratus anterior plane block
• multimodal treatment
• opioid
• postoperative pain