The impact of ultrasound-guided serratus anterior plane block on postoperative pulmonary function, immune function, and recovery in patients undergoing VATS lobectomy for lung cancer

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Background VATS has a high degree of minimally invasive in the treatment of lung cancer, however, post-operative pain and inflammation can cause damage to pulmonary and immune function. US-Guided SAPB can be advantageous for pain relief and prognosis. To explore the effects of ultrasound-guided serratus anterior plane block (SAPB) on postoperative pulmonary function, immune function, and rehabilitation in patients undergoing VATS due to lung cancer. Methods Sixty patients who underwent VATS for lung cancer were reviewed and were divided into SAPB (n=32) and control (n=28) groups according to the different anesthesia of the surgery. In group SAPB, ultrasound-guided serratus anterior plane block was conducted with conventional general anesthesia whereas the control group underwent only conventional general anesthesia. Postoperatively, pulmonary function (FEV1, FVC), immune function (CD4+/CD8+, IL-6, and TNF- α), VAS, post-operative complications, and recovery (time to walking in full quadruped position, and hospital stay) were measured at 24 and 48 hours after surgery. Results Postoperative pulmonary function was better in the SAPB group than in the control group during the operation, with higher levels of FEV1 and FVC at both 24 h and 48 h post-operation (P < 0.05). Compared with the control group, the CD4^+/CD8^+ ratio as well as IL-6 and TNF-α were decreased in the immune function of the two groups (all P < 0.05). In addition, the postoperative pain scores, complication rate, ambulation and duration of hospitalization were significantly lower in SAPB group than those in control group (P < 0.05). Conclusions Ultrasound-guided serratus anterior plane block has a role in improving postoperative lung function, reducing inflammatory response, and enhancing immune function in lung cancer patients undergoing VATS. This is a safe and efficient anesthetic technique and justifies clinical.

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