Ultrasound-Guided Erector Spinae Plane Block and Thoracic Paravertebral Block for Postoperative Analgesia Management Following Video-Assisted Thoracic Surgery: A Prospective, Randomized, Controlled Study

Abstract

Objective: Evaluation of the effectiveness of ultrasound (US)-guided erector spinae plane block (ESPB) and thoracic paravertebral block (TPVB) compared to no intervention control group for postoperative pain management in video assisted thoracic surgery (VATS) patients. Method: Three groups -Group ESPB, Group TPVB and the control group (n=30 per group) were included in this prospective, randomized, controlled study. The US-guided blocks were performed preoperatively in the ESPB and TPVB groups. Intravenous patient-controlled postoperative analgesia via fentanyl was administered in all of the patients. The patients were evaluated using visual analogue scale (VAS) scores, opioid consumption, and adverse events. Results: At all time intervals fentanyl consumption and VAS scores were significantly lower both in ESPB and TPVB groups compared to the control group (p<0.001). Block procedure time was significantly lower and success of one time puncture was higher in Group ESPB as compared with that in Group TPVB (p<0.001). Conclusion: ESPB and TPVB provide more effective analgesia compared to control group in patients who underwent video-assisted thoracic surgery. ESPB had a shorter procedural time and higher success of single-shot technique compared to TPVB.

Postoperative analgesic effects of paravertebral block versus erector spinae plane block for thoracic and breast surgery: A meta-analysis

“…Six studies [ 18 , 20 – 24 ] displayed a high risk of bias arising from detection, attrition and reporting. The remaining four articles [ 19 , 25 – 27 ] had unclear risks of bias. The outcomes of risk assessment are presented in Fig 2 .…”

“…Pooled results revealed a higher incidence of additional analgesia in the ESPB group compared with that in the PVB group (RR: 0.53, 95% CI: 0.29 to 0.97, P = 0.04, I 2 = 62%; Fig 7 ). After performing the sensitivity analysis by omitting the study by Çiftçi B (2020) [ 19 ], no heterogeneity was found among the remaining trials ( I 2 = 0), and the pooled results were unaltered.…”

Ultrasound-guided erector spinae plane block versus rhomboid intercostal block for postoperative analgesia following thoracotomy: a prospective, randomized, controlled study

“…| https://doi.org/10.22541/au.163323122.27799773/v1 | This a preprint and has not been peer reviewed. Data may be preliminary.¸C iftçi et al 16 observed post-thoracotomy analgesic consumption quantities, VAS scores, and postoperative nausea-vomiting levels to be lower in the ESPB group than the control group. In our study, there was no significant difference between the groups in terms of their nausea-vomiting levels.…”

Regional analgesia techniques for video-assisted thoracic surgery: a frequentist network meta-analysis

“…17 [25][26][27][28]30,31,33,35,[37][38][39][40][41][42][43][44][45] RCTs reported opioid consumption and 18 [25,26,28,[30][31][32][33][34][35][36][38][39][40][41][42][43][44][45],…”

“…16 [25,26,[28][29][30][31][32][33][34][35][38][39][40][41][42][43][44] , 17 [25][26][27]29,30,[33][34][35][36][38][39][40][41][42][43][44][45] RCTs reported pain score for each time period during the postoperative 24 hours. The networks for TPVB and Control were greater than the networks for other blocks, followed ESPB and Control.…”