Comparison of perioperative analgesic efficacy between serratus anterior plane block and thoracic paravertebral block in adult patients undergoing thoracic and breast surgeries: a systematic review and meta-analysis
Abstract
Background: Serratus anterior plane block (SAPB) and thoracic paravertebral block (TPVB) are widely used regional anesthesia techniques for postoperative analgesia and are generally considered safe and effective. However, the comparative efficacy remains inconclusive. This systematic review and meta-analysis of randomized controlled trials (RCTs) aims to evaluate the perioperative analgesic efficacy of SAPB versus TPVB in adult patients undergoing thoracic and breast surgeries.
Methods: A comprehensive literature search was conducted in PubMed, EMBASE, Web of Science, Cochrane library, ClinicalTrial.gov, and Google Scholar up to February 28, 2025. Primary outcomes included time to first analgesic request (TFAR), 24-h total analgesic consumption (TAC) postoperatively, and 24-h postoperative pain scores at rest. Secondary outcomes comprised pain scores at various postoperative timepoints, intraoperative fentanyl consumption, length of hospital stay, patient satisfaction with analgesia, and incidence of complications. A random-effect model was applied for the meta-analysis.
Results: Twenty-eight 28 RCTs comprising 1796 patients were included. No significant differences were found between SAPB and TPVB in TFAR (mean difference [MD] = -0.68 h, 95% confidence interval [CI]: -1.55 to 0.18, P = 0.122), 24-h pain scores at rest (MD = 0.14, 95%CI: -0.14 to 0.42, P = 0.334), other postoperative pain scores, length of hospital stay, patient satisfaction, or incidence of postoperative…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,796 participants or records.
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