Effects of serratus plane block and epidural analgesia on stress hormones after thoracoscopic lung surgery: a randomized trial.
Serratus-intercostal plane block (SPB) is performed in thoracic surgery and breast cancer surgery because it is safer and easier to perform than epidural anesthesia. However, the effect of SPB on stress hormones has not been investigated. Patients with lung cancer who were scheduled to undergo video-assisted thoracoscopic surgery (VATS) during the period from September 2017 to April 2018 were included in this single-center randomized trial. The institutional ethics committee approved this study (approval No. 2802-1). Patients were assigned to group B (SPB) or group E (epidural anesthesia). Levobupivacaine was administered as a local anesthetic to either the epidural space or serratus plane space. Blood samples were taken to measure levels of stress hormones including adrenaline, noradrenaline, dopamine, cortisol, and glucose at the induction of anesthesia and on the day following surgery. Sixteen patients were included in the current study. Seven of those patients were assigned to group B and the other 9 patients were assigned to group E. Plasma adrenaline level in group B was significantly higher than that in group E postoperatively (P = 0.007). However, other markers were not different between the two groups, and there was no difference in pain scores between the two groups. In conclusion, SPB is an alternative analgesic method to epidural anesthesia in patients undergoing VATS.