{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T14:50:08Z","timestamp":1782226208845,"version":"3.54.5"},"reference-count":28,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Academic Medical Organization of Southwestern Ontario(AMOSO) Innovation Fund","award":["#INN22-001"],"award-info":[{"award-number":["#INN22-001"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2026,6,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Video-assisted thoracoscopic surgery (VATS) offers numerous advantages over open surgery; nevertheless, it remains associated with significant postoperative pain. Multiple regional anesthesia techniques have been explored, and the serratus anterior plane block (SAPB) has emerged as a promising option; however, evidence on the use of continuous SAPB infusion for quality of recovery (QoR-40) remains limited. We hypothesized that continuous SAPB infusion, combined with multimodal analgesia, could improve QoR-40 after VATS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, double-blind, randomized controlled trial, adults undergoing elective VATS received an infusion of either 0.2% ropivacaine or saline via a SAPB catheter, in addition to standardized multimodal analgesia. The primary outcome was the QoR-40 score on postoperative day (POD) 1. Secondary outcomes included QoR-40 scores on POD 2\u20134, pain scores, opioid consumption in intravenous morphine milligram equivalents (IV MME), length of hospital stay (LOS), complications, and 30-day readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 173 patients were analyzed (SAPB: n=88; control: n=85). Median QoR-40 scores on POD 1 were higher in the SAPB group (176 (166\u2013184) vs 172 (159\u2013183); p=0.1036), and remained higher across POD 2 to 4, although not statistically significant. SAPB significantly reduced opioid consumption in recovery (8.0\u00b17.4\u2009vs 10.6\u00b19.3\u2009IV MME; p=0.0388) and on POD 1 (12.73\u00b110.75\u2009vs 16.45\u00b112.17\u2009IV MME; p=0.0349). LOS was also lower but not statistically significant by 0.8\u2009days (2.69\u00b11.76 vs 3.50\u00b14.01; p=0.0872). Pain scores, complications, and 30-day readmissions were similar between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this prospective, double-blind, randomized, placebo-controlled trial, continuous SAPB catheter infusion did not improve the primary outcome (QoR-40), and the observed differences in secondary outcomes should be interpreted as exploratory. Larger studies are needed to confirm effects on patient-reported recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2026-107618","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T13:55:15Z","timestamp":1782222915000},"page":"rapm-2026-107618","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of continuous serratus plane analgesia on quality of recovery after video-assisted thoracic surgery: a prospective double-blind, randomized, placebo-controlled trial"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct04990713","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04990713","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-7844","authenticated-orcid":false,"given":"Abhijit","family":"Biswas","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6089-3399","authenticated-orcid":false,"given":"Hamza","family":"Zidan","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8762-8500","authenticated-orcid":false,"given":"Lauren","family":"Kolodzey","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamal","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8036-3319","authenticated-orcid":false,"given":"Mahesh","family":"Nagappa","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7751-098X","authenticated-orcid":false,"given":"Lee-Anne","family":"Fochesato","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9876-5891","authenticated-orcid":false,"given":"Dalilah","family":"Fortin","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Surgery, Schulich school of Medicine and Dentistry, Western Univeristy, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Inculet","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Department of Surgery, Schulich school of Medicine and Dentistry, Western Univeristy, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8418-1528","authenticated-orcid":false,"given":"Cheng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4331-5972","authenticated-orcid":false,"given":"Mohammad","family":"Misurati","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0668-4733","authenticated-orcid":false,"given":"George","family":"Nicolaou","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8146-1084","authenticated-orcid":false,"given":"Julio Cesar","family":"Gomez Tamayo","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative 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