The purpose of this article is to systematically evaluate the impact of ultrasound-guided rhomboid intercostal and subcostal serratus (RISS) plane block on perioperative analgesia and safety in patients undergoing thoracic surgery. Retrieve Cochrane, Pubmed, Embase, Wanfang, VIP, and CNKI to collect randomized controlled trials on the perioperative analgesic effect and safety of ultrasound guided RISS in patients undergoing thoracic surgery. The search was conducted from the establishment of the database until February 2024. According to the Cochrane guidance manual, literature was independently screened, data was extracted, and the risk of bias was evaluated for inclusion in the study, using RevMan 5 Perform meta-analysis using 3 software. A total of 4 RCTs were included, with a total of 230 patients, 115 in the RISS group and 115 in the control group (Control group). Compared with the Control group, the RISS group showed a significant decrease in resting state pain scores at 2 hours postoperatively (MD=-1.55, 95% CI -1.64-1.46, P<0.0001), 6 hours postoperatively (MD=-1.35, 95% CI -1.46-1.24, P<0.0001), 12 hours postoperatively (MD=-1.20, 95% CI -1.33-1.08, P<0.0001), 24 hours postoperatively (MD=-1.09, 95% CI -1.21-0.96, P<0.0001), and 48 hours postoperatively (MD=-0.32, 95% CI -0.44-0.21, P<0.0001). Compared with the Control group, the RISS group showed a significant decrease in motor pain scores at 2 hours post surgery (MD=-1.70, 95% CI -1.86-1.54, P<0.0001), 6 hours post surgery (MD=-1.38, 95% CI -1.61-1.16, P<0.0001), 12 hours post surgery (MD=-1.79, 95% CI -1.99-1.59, P<0.0001), and 24 hours post surgery (MD=-1.11, 95% CI -1.29-0.93, P<0.0001). Compared with the Control group, the RISS group showed a significant decrease in the effective number of postoperative analgesia pump presses (MD=-6.46, 95% CI -6.90-6.01, P<0.0001), the number of postoperative salvage analgesia cases (RR=0.11, 95% CI 0.05-0.23, P<0.0001), and the incidence of postoperative nausea and vomiting (RR=0.27, 95% CI 0.12-0.64, P=0.003).Current clinical evidence suggests that ultrasound-guided arcuate flexible RISS combined with general anesthesia is more effective in postoperative analgesia of thoracic surgery than simple general anesthesia, while reducing the incidence of adverse reactions such as nausea and vomiting.

Huang Xiaoqing, Liang Yu, Yuan Libang. Meta analysis of the effect of ultrasound-guided rhomboid intercostal and sub–serratus on perioperative analgesia in patients undergoing thoracic surgery. Academic Journal of Medicine & Health Sciences (2024), Vol. 5, Issue 4: 13-20. https://doi.org/10.25236/AJMHS.2024.050402.

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