Comparison of the Efficacy of Two Different Plane Blocks in Isolated Bypass Surgery: A Prospective Observational Study

J Cardiothorac Vasc Anesth. 2022 Dec;36(12):4333-4340. doi: 10.1053/j.jvca.2022.08.002. Epub 2022 Aug 12.


Objective: This study evaluated the effects of serratus anterior plane block (SPB) and its combination with transverse thoracic muscle plane block (TTPB) on analgesia, opioid consumption, incentive spirometry performance, and patient comfort.

Design: A prospective, observational study.

Setting: A university hospital.

Participants: Adult patients scheduled for elective cardiac surgery with cardiopulmonary bypass.

Interventions: Patients who received intravenous patient-controlled analgesia only were labeled as the control group. Patients who received additional SPB were labeled as the SPB group, and patients who received additional SPB and TTPB were labeled as the SPB+TTPB group. The visual analog scores for pain (VAS), time to first analgesic requirement, total tramadol requirement, incentive spirometry values, and patient comfort indices were recorded during the first 36 postoperative hours.

Measurements and main results: From October 2020 to October 2021, data from 95 patients were analyzed. The VAS score was lower in the SPB+TTPB group at 0, 14, and 18 hours (p < 0.001, p = 0.028, p = 0.047, respectively). Time to first analgesic was longer in the SPB+TTPB group (8 hours v 0-2 hours, p = 0.001). Total tramadol consumption was similar among groups. Incentive spirometer performance was superior in the SPB+TTPB group (p < 0.001). The SPB group had similar success at 0, 14, and 18 hours.

Conclusion: Although pain scores and opioid consumption were similar, the addition of TTPB to SPB improved pain scores during patient mobilization and incentive spirometry capacity.

Keywords: coronary artery bypass surgery; patient-controlled analgesia; postoperative pain; regional anesthesia; truncal blocks.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Analgesia, Patient-Controlled
  • Analgesics, Opioid
  • Humans
  • Pain Measurement
  • Pain, Postoperative* / diagnosis
  • Pain, Postoperative* / prevention & control
  • Prospective Studies
  • Tramadol* / therapeutic use
  • Ultrasonography, Interventional


  • Analgesics, Opioid
  • Tramadol