The Effects of Erector Spinae Plane Block on Perioperative Opioid Consumption and Rehabilitation in Video Assisted Thoracic Surgery

Abstract

Background The present study aimed to observe whether the ultrasound-guided continuous erector spinae plane block (ESPB) has an effect on opioid consumption and postoperative rehabilitation in patients who undergo video-assisted thoracic surgery (VATS).Methods In this prospective study, 120 patients aged 20–70 yrs, undergoing elective VATS, were randomly allocated to one of three groups: Group C (General anaesthesia with patient-controlled intravenous analgesia [PCIA]), Group T (General anaesthesia with patient-controlled epidural analgesia [PCEA]), or Group E (General anaesthesia with continuous ESPB and PCIA). The perioperative opioid consumption; VAS scores; preoperative and postoperative QoR-15 score; and postoperative opioid-related adverse events were all assessed.Results The intraoperative sufentanil consumption in group T and E was significantly lower than that in group C (both P < 0.001), and the postoperative sufentanil consumption in group E was also significantly lower than that of group C (P = 0.001). Compared with group C, the VAS scores at rest or during coughing immediately out of the post-anesthesia care unit (PACU), at postoperative 6h, 12h, and 24h, were significantly lower in group T (P < 0.05). However, the VAS scores in group E were lower than those of group C only at rest at postoperative 6h and 12h (P < 0.05), and were significantly higher than those of group T at all study times (P < 0.05).Conclusion Ultrasound-guided continuous ESPB could significantly reduce perioperative opioid consumption in VATS and improve postoperative rehabilitation. However, these effects were inferior to those provided by TEA.Trial registration The present study was prospectively registered at http://www.chictr.org/cn /(Registration number: ChiCTR1900023050); Registration date: May 8,2019

Comparison of analgesic efficacy of different local anesthetic volumes for erector spinae plane block in thoracotomy patients; a prospective randomized trial

“…still accepted gold standard method in the treatment of post-thoracotomy pain [4]. However, serious complications such as dural puncture, sympathetic block, spinal hematoma, and epidural abscess can also be seen due to epidural application [5].…”

“…However, serious complications such as dural puncture, sympathetic block, spinal hematoma, and epidural abscess can also be seen due to epidural application [5]. Thoracic paravertebral block (TPVB) application has also been used in recent years due to the lower incidence of side effects such as hypotension, urinary retention, and nausea and vomiting compared to TEA [4,6]. With the widespread use of ultrasound (US) in recent years, different thoracic wall block techniques, which are claimed to cause fewer complications, have begun to be applied [7].…”

A prospective double-blinded randomized control trial comparing erector spinae plane block to thoracic epidural analgesia for postoperative pain in video-assisted thoracic surgery

“…Our findings are consistent with the previous study that postoperative pain at rest and coughing in continuous ESP block were significantly higher than TEA 24 hours after surgery. 28 On the contrary, Nagaraja et al 10 have reported comparable pain scores in both TEA and ESP block groups in the early postoperative period after cardiac surgery and that an ESP block might be superior to TEA at 24 h, 36 h, and 48 h, both at rest and while coughing.…”