{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:08:52Z","timestamp":1788394132332,"version":"build-2803163510"},"reference-count":45,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Video-assisted thoracoscopic surgery (VATS) is a minimally invasive diagnostic and therapeutic procedure utilized in various thoracic conditions. VATS has grown in popularity with ever-expanding knowledge of enhanced recovery after surgery (ERAS) protocols and its benefits regarding patient care and outcomes. Pain control following VATS is of utmost importance to minimize the complication risk. Options for pain control following VATS have traditionally included systemic IV analgesia but have evolved to include loco-regional analgesia as well. The serratus anterior plane block (SAPB) is one form of loco-regional analgesia utilized in VATS that has been shown to provide effective pain control of the anterolateral chest wall. Patients who received SAPB compared to control methods of anesthesia demonstrated significant decreases in postoperative pain and postoperative opioid consumption. SAPB is effective and offers a promising safety profile as the block is typically more superficial than other types of loco-regional analgesia. This review outlines the recent literature surrounding the use of SAPB for pain control in VATS.<\/jats:p>","DOI":"10.3390\/medicina61061010","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T08:12:47Z","timestamp":1748419967000},"page":"1010","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Serratus Anterior Plane Block for Pain Management After Video-Assisted Thoracoscopic Surgeries: A Narrative Review"],"prefix":"10.3390","volume":"61","author":[{"given":"Shahab","family":"Ahmadzadeh","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Macie A.","family":"Serio","sequence":"additional","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Nguyen","sequence":"additional","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drew R.","family":"Dethloff","sequence":"additional","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Robichaux","sequence":"additional","affiliation":[{"name":"School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chizoba N.","family":"Mosieri","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4545-4523","authenticated-orcid":false,"given":"Sahar","family":"Shekoohi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2464-0187","authenticated-orcid":false,"given":"Alan D.","family":"Kaye","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"},{"name":"Department of Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Redden, M.D., Chin, T.Y., and van Driel, M.L. (2017). Surgical versus non-surgical management for pleural empyema. Cochrane Database of Systematic Reviews, John Wiley & Sons, Ltd.","DOI":"10.1002\/14651858.CD010651.pub2"},{"key":"ref_2","unstructured":"(2025, February 12). Video-Assisted Thoracoscopic Surgery\u2014Taking a Step into the Future | European Journal of Cardio-Thoracic Surgery | Oxford Academic. Available online: https:\/\/academic.oup.com\/ejcts\/article\/51\/4\/694\/2698411."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1001\/jamasurg.2016.4952","article-title":"Enhanced Recovery After Surgery: A Review","volume":"152","author":"Ljungqvist","year":"2017","journal-title":"JAMA Surg."},{"key":"ref_4","unstructured":"(2025, February 14). Lobectomy by Video-Assisted Thoracic Surgery (VATS) Versus Thoracotomy for Lung Cancer\u2014ScienceDirect. Available online: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0022522309004826?via%3Dihub."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/ACO.0000000000000282","article-title":"Fast track in thoracic surgery and anaesthesia: Update of concepts","volume":"29","author":"Loop","year":"2016","journal-title":"Curr. Opin. Anesthesiol."},{"key":"ref_6","unstructured":"(2025, February 14). Essential Elements of Multimodal Analgesia in Enhanced Recovery After Surgery (ERAS) Guidelines\u2014ClinicalKey, Available online: https:\/\/www.clinicalkey.com\/#!\/content\/playContent\/1-s2.0-S193222751730023X?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS193222751730023X%3Fshowall%3Dtrue&referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.thorsurg.2015.07.005","article-title":"Pain Management Following Thoracic Surgery","volume":"25","author":"Elmore","year":"2015","journal-title":"Thorac. Surg. Clin."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3061","DOI":"10.1007\/s00464-024-10821-y","article-title":"Effect of an intravenous acetaminophen\/ibuprofen fixed-dose combination on postoperative opioid consumption and pain after video-assisted thoracic surgery: A double-blind randomized controlled trial","volume":"38","author":"Lee","year":"2024","journal-title":"Surg. Endosc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S555","DOI":"10.21037\/jtd.2017.12.86","article-title":"Enhanced recovery pathways in thoracic surgery from Italian VATS Group: Peri-operative analgesia protocols","volume":"10","author":"Piccioni","year":"2018","journal-title":"J. Thorac. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1002\/ejp.1533","article-title":"Ultrasound-guided continuous deep serratus anterior plane block versus continuous thoracic paravertebral block for perioperative analgesia in videoscopic-assisted thoracic surgery","volume":"24","author":"Hanley","year":"2020","journal-title":"Eur. J. Pain"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1007\/s40122-021-00322-4","article-title":"The Role of Serratus Anterior Plane Block During in Video-Assisted Thoracoscopic Surgery","volume":"10","author":"Chen","year":"2021","journal-title":"Pain Ther."},{"key":"ref_12","unstructured":"(2025, January 28). Anatomy, Thorax, Serratus Anterior Muscles\u2014StatPearls\u2014NCBI Bookshelf, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK531457\/."},{"key":"ref_13","unstructured":"(2025, January 28). Ultrasound-Guided Serratus Plane Block for ED Rib Fracture Pain Control\u2014ScienceDirect. Available online: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0735675716304156?via%3Dihub."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/papr.12482","article-title":"Ultrasound-Guided Serratus Plane Block for Treatment of Postmastectomy Pain Syndromes in Breast Cancer Patients: A Case Series","volume":"17","author":"Zocca","year":"2017","journal-title":"Pain Pract."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1111\/anae.12344","article-title":"Serratus plane block: A novel ultrasound-guided thoracic wall nerve block","volume":"68","author":"Blanco","year":"2013","journal-title":"Anaesthesia"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1053\/j.jvca.2016.08.023","article-title":"Ultrasound-Guided Serratus Anterior Plane Block Versus Thoracic Epidural Analgesia for Thoracotomy Pain","volume":"31","author":"Khalil","year":"2017","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_17","unstructured":"Southgate, S.J., River, G.F., and Herbst, M.K. (2025, January 28). Ultrasound-Guided Serratus Anterior Blocks, StatPearls, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK538476\/."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1111\/anae.14424","article-title":"A randomised trial of serratus anterior plane block for analgesia after thoracoscopic surgery","volume":"73","author":"Park","year":"2018","journal-title":"Anaesthesia"},{"key":"ref_19","first-page":"564","article-title":"Quality of postoperative recovery after breast surgery. General anaesthesia combined with paravertebral versus serratus-intercostal block","volume":"63","author":"Herrero","year":"2016","journal-title":"Rev. Espa\u00f1ola Anestesiol. Y Reanim."},{"key":"ref_20","first-page":"280","article-title":"Ultrasound-Guided Serratus Anterior Plane Block in Breast Reconstruction Surgery","volume":"6","author":"Khemka","year":"2016","journal-title":"AA Pract."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kunhabdulla, N., Agarwal, A., Gaur, A., Gautam, S., Gupta, R., and Agarwal, A. (2025, January 28). Serratus Anterior Plane Block for Multiple Rib Fractures. Available online: https:\/\/www.painphysicianjournal.com\/linkout?issn=&vol=17&page=E553.","DOI":"10.36076\/ppj.2014\/17\/E553"},{"key":"ref_22","first-page":"132","article-title":"Case Report of Serratus Plane Catheter for Pain Management in a Patient With Multiple Rib Fractures and an Inferior Scapular Fracture","volume":"8","author":"Fu","year":"2017","journal-title":"AA Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1002\/ejp.1473","article-title":"The impact of ultrasound-guided continuous serratus anterior plane block versus intravenous patient-controlled analgesia on the incidence and severity of post-thoracotomy pain syndrome: A randomized, controlled study","volume":"24","author":"Reyad","year":"2020","journal-title":"Eur. J. Pain"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"E421","DOI":"10.36076\/ppj.2015\/18\/E421","article-title":"Serratus Anterior Plane Block: A New AnalgesicTechnique for Post-Thoracotomy Pain","volume":"18","author":"Gautam","year":"2015","journal-title":"Pain Phys."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.bja.2017.11.104","article-title":"Should continuous rather than single-injection interscalene block be routinely offered for major shoulder surgery? A meta-analysis of the analgesic and side-effects profiles","volume":"120","author":"Vorobeichik","year":"2018","journal-title":"Br. J. Anaesth."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jpain.2015.12.008","article-title":"Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists\u2019 Committee on Regional Anesthesia, Executive Committee, and Administrative Council","volume":"17","author":"Chou","year":"2016","journal-title":"J. Pain"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"E481","DOI":"10.36076\/ppj\/2019.19.E481","article-title":"Serratus Plane Block for Persistent Painafter Partial Mastectomy and Axillary NodeDissection","volume":"19","author":"Takimot","year":"2016","journal-title":"Pain Phys."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1097\/00000542-200603000-00027","article-title":"Preventing and Treating Pain after Thoracic Surgery","volume":"104","author":"Gottschalk","year":"2006","journal-title":"Anesthesiology"},{"key":"ref_29","first-page":"322","article-title":"Serratus Anterior Plane Block to Address Postthoracotomy and Chest Tube-Related Pain: A Report on 3 Cases","volume":"8","author":"Chu","year":"2017","journal-title":"AA Pract."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.sjpain.2009.10.003","article-title":"A systematic review of comparative studies indicates that paravertebral block is neither superior nor safer than epidural analgesia for pain after thoracotomy","volume":"1","author":"Norum","year":"2010","journal-title":"Scand. J. Pain"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s11748-018-0936-8","article-title":"Comparison of the analgesic effects of modified continuous intercostal block and paravertebral block under surgeon\u2019s direct vision after video-assisted thoracic surgery: A randomized clinical trial","volume":"66","author":"Kadomatsu","year":"2018","journal-title":"Gen. Thorac. Cardiovasc. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Gulati, S., Housman, B., and Flores, R. (2024). Approaching lobectomy in a VIOLET tinted world: Video-assisted thoracoscopic surgery (VATS) vs. open thoracotomy for lobectomy. Video-Assist. Thorac. Surg., 9.","DOI":"10.21037\/vats-23-76"},{"key":"ref_33","unstructured":"Mehrotra, M., D\u2019Cruz, J.R., Bishop, M.A., and Arthur, M.E. (2025, March 05). Video-Assisted Thoracoscopy, StatPearls, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK532952\/."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1093\/ejcts\/ezy343","article-title":"Intraoperative conversion during video-assisted thoracoscopy does not constitute a treatment failure\u2020","volume":"55","author":"Fourdrain","year":"2019","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_35","first-page":"S177","article-title":"Techniques of VATS lobectomy","volume":"5","author":"Mitchell","year":"2013","journal-title":"J. Thorac. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"820","DOI":"10.21037\/acs-2022-urats-11","article-title":"Transition from multiportal video-assisted thoracic surgery to uniportal video-assisted thoracic surgery\u2026 and evolution to uniportal robotic-assisted thoracic surgery?","volume":"12","author":"Sihoe","year":"2023","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.anclin.2008.01.007","article-title":"Post-thoracotomy Pain Management Problems","volume":"26","author":"Gerner","year":"2008","journal-title":"Anesthesiol. Clin."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Li, J., Wang, X., Wang, Y., and Zhang, W. (2023). Analgesic effectiveness of serratus anterior plane block in patients undergoing video-assisted thoracoscopic surgery: A systematic review and updated meta-analysis of randomized controlled trials. BMC Anesthesiol., 23.","DOI":"10.1186\/s12871-023-02197-8"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"4215","DOI":"10.1016\/j.asjsur.2022.11.125","article-title":"Ultrasound-guided serratus anterior plane block versus paravertebral block on postoperation analgesia and safety following the video-assisted thoracic surgery: A prospective, randomized, double-blinded non-inferiority clinical trial","volume":"46","author":"Wang","year":"2023","journal-title":"Asian J. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.55730\/1300-0144.5881","article-title":"Comparison of combined deep and superficial serratus anterior block with thoracic paravertebral block for postoperative pain in patients undergoing video-assisted thoracoscopic surgery","volume":"54","author":"Zengin","year":"2024","journal-title":"Turk. J. Med. Sci."},{"key":"ref_41","first-page":"329","article-title":"Efficacy and safety of the serratus anterior block compared to thoracic epidural analgesia in surgery: Systematic review and meta-analysis","volume":"35","author":"Sumartono","year":"2023","journal-title":"Tzu Chi Med. J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1186\/s13019-024-02611-3","article-title":"The association of regional block with intraoperative opioid consumption in patients undergoing video-assisted thoracoscopic surgery: A single-center, retrospective study","volume":"19","author":"Xiang","year":"2024","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_43","first-page":"134","article-title":"A comparison of the analgesic efficacy of serratus anterior plane block vs. paravertebral nerve block for video-assisted thoracic surgery: A randomized controlled trial","volume":"17","author":"Zhang","year":"2022","journal-title":"Videosurg. Other Miniinvasive Tech."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.athoracsur.2021.02.032","article-title":"Continuous Serratus Anterior Plane Block Improved Early Pulmonary Function After Lung Cancer Surgical Procedure","volume":"113","author":"Gao","year":"2022","journal-title":"Ann. Thorac. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"234","DOI":"10.3344\/kjp.2021.34.2.234","article-title":"Comparison of ultrasonography guided serratus anterior plane block and thoracic paravertebral block in video-assisted thoracoscopic surgery: A prospective randomized double-blind study","volume":"34","author":"Baytar","year":"2021","journal-title":"Korean J. Pain"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/6\/1010\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:42:12Z","timestamp":1760031732000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/6\/1010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,28]]},"references-count":45,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["medicina61061010"],"URL":"https:\/\/doi.org\/10.3390\/medicina61061010","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,28]]}}}