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Serratus Anterior Plane Block and Postoperative Pain Control in Obese Patients Undergoing S-ICD Implantation: A Case Series and literature analysis
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  • Francesco Coletta,
  • Francesca Schettino,
  • Antonio Tomasello,
  • Crescenzo Sala,
  • Massimo Pisanti,
  • Romolo Villani
Francesco Coletta
Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli

Corresponding Author:[email protected]

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Francesca Schettino
Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli
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Antonio Tomasello
Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli
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Crescenzo Sala
Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli
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Massimo Pisanti
Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli
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Romolo Villani
Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli
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Abstract

Background Subcutaneous implantable cardioverter-defibrillator (S-ICD) procedures are frequently performed under analgosedation or general anesthesia, leading to prolonged postoperative hospital stays and increased costs. This anesthetic technique may also have a greater hemodynamic impact, particularly in obese and cardiac patients. However, an alternative anesthetic technique can be employed: ultrasound-guided serratus anterior plane block (US-SAPB). Methods We analyzed the anesthetic clinical course in 5 patients, 3 males and 2 females, who were obese (BMI >= 30) and underwent S-ICD implantation for primary prevention using a two-incision intermuscular technique and ultrasound-guided serratus anterior plane block. All patients had a left ventricular ejection fraction less than or equal to 35%. Conclusion It significantly facilitated pain control during the procedure and, especially, in the postoperative phase. However, the data available in the literature are mostly derived from case reports and small comparative studies. Therefore, further studies with a larger sample size and direct comparison with general anesthesia or deep sedation are needed.