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Randomized Controlled Trial
. 2022 Jan;70(1):64-71.
doi: 10.1007/s11748-021-01687-1. Epub 2021 Aug 4.

Effects of continuous erector spinae plane block on postoperative pain in video-assisted thoracoscopic surgery: a randomized controlled study

Özcan Pişkin  1 , Mertol Gökçe  2 , Bülent Altınsoy  3 , Çağdaş Baytar  4 , Bengü Gülhan Aydın  4 , Rahşan Dilek Okyay  4 , Gamze Küçükosman  4 , Keziban Bollucuoğlu  4 , Hilal Ayoğlu  4
Affiliations
Randomized Controlled Trial

Effects of continuous erector spinae plane block on postoperative pain in video-assisted thoracoscopic surgery: a randomized controlled study

Özcan Pişkin et al. Gen Thorac Cardiovasc Surg. 2022 Jan.

Abstract

Background: The aim of this prospective, randomized, controlled study was to evaluate the analgesic effect of ultrasonography (USG) guided continuous erector spinae plane block (ESPB) for postoperative analgesia in video-assisted thoracoscopic surgery (VATS).

Methods: Eighty American Society of Anesthesiologists (ASA) physical status I-III patients aged 18-75 and who were to undergo VATS were included in this study. Randomization was performed in 2 groups, continuous ESPB (ESPB Group) and no intervention (Control Group). 20 mL of 0.25% bupivacaine was administered for the block. Immediately after surgery, the patient received continuous infusion of 0.125% bupivacaine at 4 mL h-1 via the catheter inserted for the block. Patients in both groups received tramadol via an intravenous patient-controlled analgesia device. Tramadol and meperidine consumption, visual analog scale pain scores and opioid-related side effects were recorded at 0, 1, 4, 8, 12, 24, 36, and 48 h postoperatively.

Results: The use of continuous ESPB in VATS significantly decreased the amount of tramadol used in the first 48 h postoperatively (P < 0.001). There was a statistically significant difference in the number of meperidine rescue analgesia administered between the ESPB and Control Groups (P < 0.001). While the incidences of nausea and itching were higher in Control Group, there were no differences in terms of the other side effects between the groups.

Conclusions: This study shows that USG-guided continuous ESPB provides adequate analgesia following VATS as part of multimodal analgesia. Continuous ESPB significantly reduced opioid consumption and opioid-related side effects compared to those in the Control Group.

Keywords: Analgesia; Analgesics; Intermediate back muscles; Nerve block; Opioid; Pain; Paraspinal muscles; Patient-controlled; Postoperative; Thoracic surgery; Tramadol; Ultrasonography; Video-assisted.

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