Ultrasound-guided Continuous Low Serratus Anterior Plane Block in Hepatocellular Carcinoma Surgery

Study Overview
=================
Brief Summary
-----------------
To investigate the clinical application of ultrasound-guided continuous low serratus anterior plane block in open surgery for hepatocellular carcinoma.

Detailed Description
-----------------
METHODS: Patients with hepatocellular carcinoma who attended our hospital from January 2021 to April 2023 were divided into CS group and N group according to the random number table method; CS group underwent ultrasound-guided continuous low anterior serratus plane block and N group underwent ultrasound-guided single anterior serratus plane block combined with rectus abdominis sheath block; the operation time, anesthesia time, incision length, sensory block time and sensory block maintenance time were counted and recorded. Pain score (NRS) was used to detect analgesia; alanine aminotransferase (ALT), liver function aspartate aminotransferase (AST), and prothrombin time (The time of thrombin, NRS) were measured by fluorescent quantitative PCR. （The time of thrombin (APTT), total bilirubin (TBIL) levels and adverse reactions.

Official Title
-----------------
The Role of Continuous Low Serratus Anterior Plane Block in Hepatocellular Carcinoma Surgery: a Randomised Clinical Trial.

Conditions
-----------------
Liver Neoplasms, Postoperative Analgesia, Serratus Anterior Plane Block

Intervention / Treatment
-----------------
* Procedure: Ultrasound-guided continuous low serratus anterior plane block
* Procedure: Ultrasound-guided single serratus anterior plane block


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age 18-60 years; ASAI-II; BMI: 18-29 kg/m2 Exclusion Criteria: Combined cardiac, cerebral, hepatic, and renal failure; Comorbid psychiatric and neuromuscular disorders; A history of allergy to anesthetic drugs; Participation in other recent clinical or drug trials.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Continuous serratus anterior plane block<br>Ultrasound-guided continuous serratus anterior plane block. | Procedure: Ultrasound-guided continuous low serratus anterior plane block<br>* Low anterior serratus plane block, move the mid-axillary line 4 and 5 intercostal puncture points are moved down and the puncture is changed to 7 and 8 intercostal.<br>|
| Active Comparator: Single serratus anterior plane block combined with rectus sheath nerve block<br>Ultrasound-guided single serratus anterior plane block combined with rectus sheath nerve block. | Procedure: Ultrasound-guided single serratus anterior plane block<br>* Ultrasound-guided single anterior saw plane block was performed, and a needle was injected between the 4th and 5th costals in the midaxillary line.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Block plane | The effect of anesthesia after ultrasound-guided nerve block was measured using planimetry, as well as the area being anesthetized. The chest wall between T2-T9 and ice cotton balls was used to assess the extent and extent of anesthesia block. | 30 minute after the surgery begins | 
| visual analogue scale | The visual analogue scale (VAS) of the patient's pain was recorded 24 hours after operation. | 24 hours after surgery | 
| visual analogue scale | The visual analogue scale (VAS) of the patient's pain was recorded 48 hours after operation. | 48 hours after surgery. | 
| visual analogue scale | The visual analogue scale (VAS) of the patient's pain was recorded 36 hours after operation. | 36 hours after surgery. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient satisfaction | The patient's satisfaction with the analgesia 2 days after surgery was recorded. The analgesic effect: 1-3 as satisfactory, 4-6 as unsatisfactory, 7-10 as ineffective | 48 hours after surgery. | 
| Remedial analgesic drug | Whether other analgesic drugs were added within 24 hours after operation was recorded | 24 hours after surgery. | 
| Intraoperative blood pressure changes | Blood pressure changes were measured directly by radial artery puncture and recorded. The changes in blood pressure and heart rate before and after excision and the use of intraoperative opioids. | 2 hours after the beginning of surgery. | 
| Intraoperative heart rate changes | The curve of the change of the operative heart rate was recorded through the anesthesia machine. | 2 hours after the beginning of surgery. | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
serratus anterior plane block, Postoperative analgesia, liver cancer