Clinical application of ultrafast channel cardiac anesthesia assisted by serratus anterior plane block in right-thoracoscopic minimally invasive cardiac surgery: a retrospective cohort study

Objectives: This study aimed to investigate the effects of ultrafast channel cardiac anesthesia assisted by serratus anterior plane block on the post-operative rehabilitation of patients undergoing right-sided thoracoscopic minimally invasive cardiac surgery, as well as the safety and feasibility of the clinical application of this technique. Background: Regional nerve block has previously been used in cardiac surgery to reduce intraoperative opioid use and promote anesthesia in fast-track and ultra-fast-track cardiac surgery. However, the clinical application of ultrafast cardiac anesthesia assisted by serratus anterior plane block (SAPB) in minimally invasive cardiac surgery under thoracoscopy has not been reported. Methods: A total of 102 patients who underwent right-sided thoracoscopic minimally invasive heart valve surgery in our center from January 2021 to August 2021 were enrolled and divided into two groups: an ultrafast channel cardiac anesthesia assisted by serratus anterior plane block (SAPB-GA) group (n=40) and a conventional general anesthesia (GA) group (n=62). The effects of ultrafast cardiac anesthesia assisted by serratus anterior plane block (SAPB) on post-operative rapid recovery as well as the safety and feasibility of its clinical application were compared and analyzed. Results: Compared to the GA group, the intraoperative use of sufentanil in the SAPB-GA group was significantly reduced (66.25±1.025, 283.31±11.362, P<0.001); the incidence of postoperative analgesia in ICU was significantly decreased (17%, 48.8%, P<0.001); the incidence of postoperative NRS≥3 in ICU was significantly decreased (15%, 37.1%, P = 0.016); and the postoperative extubation time (1(1-1), 13.84 (10.25-18.36), P<0.001), ICU stay time (28.58±2.838, 61.69±4.125, P<0.001) and postoperative hospital stay (8.08±0.313, 9.74±0.356, P=0.02) were significantly shortened; and the 24 h postoperative thoracic blood drainage was significantly reduced (209.63±25.645, 318.23±20.713, P<0.001). No statistical difference was observed in the incidence of postoperative nausea, vomiting and atelectasis between the two groups (all P>0.05). Both of the groups reported no postoperative cardiovascular events. Conclusions: Ultrafast channel cardiac anesthesia assisted by SAPB could promote the rapid postoperative recovery of patients undergoing minimally invasive cardiac surgery under a thoracoscope. This approach is safe and feasible in the clinic.