Effect of serratus anterior plane block versus fentanyl for postoperative pain control and stress response after minimally invasive cardiac surgery: Randomised controlled study

Bioinformation. 2026 Mar 31;22(3):1388-1393. doi: 10.6026/973206300221388. eCollection 2026.

ABSTRACT

Minimally invasive cardiac surgery (MICS) causes significant intercostal pain managed traditionally with opioids, risking nausea, hypoventilation and delayed recovery. Therefore, it is of interest to compare ultrasound-guided serratus anterior plane block (SAPB, n=60) versus fentanyl-based analgesia (n=60) in 120 adults undergoing right mini-thoracotomy MICS. SAPB significantly reduced 24-hour opioid requirements (12mg [IQR 8-18] versus 22mg [IQR 15-30] morphine equivalents; p<0.001) and lowered pain scores at rest/coughing (6/12h, all p<0.01). SAPB attenuated stress response (6h cortisol 18.4±6.2 versus 24.9±7.1 ug/dL, p<0.001; IL-6 68 versus 102 pg/mL, p=0.002) and reduced postoperative nausea/vomiting (PONV) (18% versus 35%) without block complications. Thus, we show SAPB as an effective opioid-sparing analgesic technique that enhances recovery and comfort in MICS patients.

PMID:42145437 | PMC:PMC13177139 | DOI:10.6026/973206300221388