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    Effects of Modified Thoracoabdominal Nerve Block Through Perichondrial Approach on Postoperative Pain and Analgaesic Consumption in Patients Undergoing Laparoscopic Cholecystectomy
    (Coll Physicians & Surgeons Pakistan, 2024) Avci, Onur; Gundogdu, Oguz; Balci, Fatih; Tekcan, Muhammed Nail
    Objective: To investigate postoperative analgaesic efficacy of modified thoracoabdominal nerve block through perichondrial approach (M-TAPA) and its effect on opioid consumption in patients undergoing laparoscopic cholecystectomy (LC) surgery.Study Design: Randomised, controlled trial.Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Sivas Cumhuriyet University, Sivas, Turkiye, from April to May 2023. Methodology: The study was conducted in two randomised groups: M-TAPA (n = 21) and control group (CG) (no block) (n = 21). All patients had standard general anaesthesia. M-TAPA patients had bilateral M-TAPA block with 0.25% bupivacaine (total volume, 40 ml) at the end of the surgery. In contrast, CG patients had only tramadol for postoperative pain. A numerical rating scale (NRS) and visual analogue scale (VAS) were used for postoperative pain assessment. Total tramadol consumption was calculated.Results: M-TAPA's NRS and VAS scores were lower in postoperative 24 hours (p<0.05). Total tramadol consumption was 116.67 +/- 32.91 mg in CG and 35.71 +/- 39.19 mg in M-TAPA (p<0.001).Conclusion: Bilateral M-TAPA block for postoperative pain control after LC surgery provided effective analgaesia for up to 24 hours and reduced total opioid consumption. Although the M-TAPA block is a novel approach, it will be a part of multimodal analgaesia for routine postoperative pain management in abdominal surgeries. However, more studies with higher numbers of patients will be needed.
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    Efficacy of serratus posterior superior intercostal plane block (SPSIPB) on post-operative pain and total analgesic consumption in patients undergoing video-assisted thoracoscopic surgery (VATS): A double-blinded randomised controlled trial
    (Wolters Kluwer Medknow Publications, 2023) Avci, Onur; Gundogdu, Oguz; Balci, Fatih; Tekcan, Muhammed N.; Ozbey, Mahmut
    Background and Aims: Serratus posterior superior intercostal plane block (SPSIPB) is a novel technique that can provide analgesia in the hemithorax, shoulder, and back of the neck. This study aimed to evaluate the post-operative analgesic effect of SPSIPB in patients undergoing video-assisted thoracoscopic surgery (VATS). Methods: It is a double-blind, randomised controlled trial. Twenty-four adult patients who underwent VATS via the uniportal technique were randomised into two groups: the SPSIPB group (n = 12) received SPSIPB along with intravenous patient-controlled analgesia (PCA) with tramadol, whereas the control group (n = 12) received only PCA with tramadol. At the end of the surgery, patients in the SPSIPB group received a unilateral SPSIPB under ultrasound guidance with the use of 30-mL bupivacaine 0.25%. The primary outcome was the numerical rating scale (NRS) scores of the patients. Secondary outcomes included the amount of tramadol and rescue analgesic (paracetamol) consumed by the patients, followed up for post-operative 24 hours. Categorical variables were compared using the Chi-Square Test. Mann-Whitney U Test was used to compare groups of variables that were not normally distributed.Results: The SPSIPB group had lower NRS values during post-operative 24 hours (P < 0.001). Mean (standard deviation) total tramadol consumption was 58.33 (26.23) mg in the SPSIPB group and 144.17 (13.11) mg in the control group (P < 0.001). Rescue analgesic need was lower in the SPSIP group in the first 18 post-operative hours (P < 0.05). Conclusion: Serratus posterior superior intercostal plane block provides good analgesia in the thoracic region after video-assisted thoracoscopic surgery.
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    Efficacy of Serratus Posterior Superior Intercostal Plane Block on Postoperative Pain and Total Analgesic Consumption in Patients Undergoing Reduction Mammoplasty Surgery: An Evidence Based Report
    (Coll Physicians & Surgeons Pakistan, 2024) Gundogdu, Oguz; Avci, Onur; Balci, Fatih; Tekcan, Muhammed Nail; Kol, Yusuf Celil
    Serratus posterior superior intercostal plane block (SPSIPB) is a novel technique that provides analgesia in shoulder, hemithorax and in the back of the neck. In this study, the efficacy of this block on postoperative pain and quality of recovery is reported in ten consecutive patients who had undergone reduction mammoplasty. Blocks were performed bilaterally with 30 ml 0.25 % bupivacaine for each side, at the end of surgery. Cumulative tramadol consumption and numerical rating scale (NRS) scores during rest (static) and coughing (dynamic) were assessed within the first postoperative 24 hours. Mean total tramadol consumption was 39 +/- 9.94 mg. NRS scores above 4 were observed in 5 patients in the dynamic NRS assessment at the postoperative 1st hour, while static and dynamic NRS scores were <= 4 at other durations. SPSIPB may play a part in postoperative multimodal analgesia following mammoplasty in the future and may reduce total analgesic consumption.
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    Is Serratus Posterior Superior Intercostal Plane Block a Novel Indication for the Management of Pain in Thoracic Acute Herpes Zoster? A Case Report
    (Lippincott Williams & Wilkins, 2024) Balci, Fatih; Tekcan, Muhammed Nail; Gundogdu, Oguz; Avci, Onur
    Postherpetic neuralgia results from varicella-zoster virus reactivation post-chickenpox infection, manifesting as persistent and severe pain lasting a minimum of 3-mo post-herpes zoster onset. Traditional postherpetic neuralgia management comprises antiviral, analgesic medications, corticosteroids, and various agents. Ultrasound-guided nerve blocks have recently emerged as a promising postherpetic neuralgia treatment. In a case involving a 58-year-old man with severe thoracic herpes zoster lesions, the serratus posterior superior intercostal plane block was employed under ultrasound guidance, significantly reducing pain scores and enhancing quality of recovery. This study underscores serratus posterior superior intercostal plane block's secure, effective role in managing thoracic herpes zoster, and mitigating postherpetic neuralgia risk. This case report represents the pioneering application of serratus posterior superior intercostal plane block for postherpetic neuralgia, offering a promising avenue for relieving patients suffering from this condition.
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    Postoperative Analgesic Efficacy of Clavipectoral Plane Block and Serratus Posterior Superior Intercostal Plane Block Combination in Clavicle Surgeries: A Report of 10 Cases
    (Lippincott Williams & Wilkins, 2024) Balci, Fatih; Tekcan, Muhammed Nail; Gundogdu, Oguz; Avci, Onur
    This case series included 10 patients who underwent clavicular fracture surgery under general anesthesia. A novel analgesic approach combining 2 distinct nerve block techniques-serratus posterior superior intercostal plane block (SPSIPB) and clavipectoral plane block (CPPB)-was used for postoperative pain management. SPSIPB provided sensory blockade for the innervation of the clavicular skin, whereas CPPB targeted the clavipectoral fascia. The combination of SPSIPB and CPPB demonstrated variable efficacy in controlling postoperative pain. Future studies may explore potential improvements through dosage optimization, the use of adjuvants, or targeting higher anatomical levels.
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    Ultrasound-Guided Serratus Posterior Superior Intercostal Plane Block in Modified Radical Mastectomy Surgeries: A Case Series
    (Lippincott Williams & Wilkins, 2024) Balci, Fatih; Tekcan, Muhammed Nail; Gundogdu, Oguz; Avci, Onur
    Effective pain management is crucial for modified radical mastectomy (MRM) surgeries. The Serratus Posterior Superior Intercostal Plane Block (SPSIPB), introduced in 2023, shows promise for postoperative analgesia. This study was designed to demonstrate the analgesic efficacy of the SPSIPB in MRM surgeries. SPSIPB was administered to 7 patients who underwent MRM for postoperative analgesia. NRS scores of patients were <= 4 and total tramadol consumption was 0 mg in 3 of 7 patients. In conclusion, SPSIPB appears to be an effective, safe, and easily applicable option for analgesia.