Efficacy of an Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia Management After Video-Assisted Thoracic Surgery: A Prospective Randomized Study

Abstract

Objectives: Investigate whether an ultrasound-guided erector spinae plane block (ESPB) can be used to manage postoperative pain in video-assisted thoracic surgery (VATS) patients.

Design: Prospective, randomized study.

Setting: Single institution, academic university hospital.

Participants: Adult patients who underwent VATS under general anesthesia between September 2018 and March 2019.

Interventions: This study was an interventional study.

Measurements and main results: A total of 60 patients were randomly assigned into 2 groups (n = 30 per group): an ESPB group and a control group. In the ESPB group, a single-shot ultrasound-guided ESPB was administered preoperatively. The control group received no such intervention. All of the patients received intravenous patient-controlled postoperative analgesia, and they were assessed using visual analogue scale (VAS) scores, opioid consumption, and adverse events. There were no statistically significant intergroup differences with respect to the age, sex, weight, American Society of Anesthesiologists status, anesthesia duration, and surgery length (p > 0.05 for each). The opioid consumption at 1, 2, 4, 8, 16, and 24 hours and the active and passive VAS scores at 0, 2, 4, 8, 16, and 24 hours were statistically lower in the ESPB group at all of the time periods when compared with the control group (p < 0.05). In the control group, the nausea and itching rates were higher, but there were no intergroup differences in terms of other adverse effects.

Conclusions: A preemptive single-shot ESPB may provide effective analgesia management after VATS.

Keywords: erector spinae plane block; postoperative analgesia; video-assisted thoracic surgery.