• Walaa Y Elsabeeny, Mostafa A Ibrahim, Nahla N Shehab, Abdelrahman Mohamed, and Mohamed A Wadod.
• Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt. Electronic address: walaa.Elsabeeny@nci.cu.edu.eg.
• J. Cardiothorac. Vasc. Anesth. 2021 Oct 1; 35 (10): 2928-2936.

ObjectivesThis study was designed to evaluate the safety and efficacy of erector spinae plane block and serratus anterior plane block versus thoracic epidural in perioperative pain control for patients with cancer undergoing lung surgeries.DesignSingle blinded, randomized, controlled trial.SettingThe study was carried out at the National Cancer Institute in Cairo, Egypt.ParticipantsFifty-one patients with cancer.InterventionsPatients were allocated randomly into three groups: thoracic epidural analgesia (TEA) group, serratus anterior plane block (SAPB) group, and erector spinae plane block (ESPB) group.Measurements And Main ResultsOutcome measures were 24 hours postoperative visual analog scale (VAS), intraoperative rescue fentanyl consumption, perioperative heart rate, mean blood pressure (mean arterial pressure [MAP]), and total postoperative morphine consumption. VAS scores at rest were significantly lower in the TEA group at the postanesthesia care unit and 24 hours. VAS scores with cough were significantly higher in the SAPB group at eight and 24 hours. The first time to receive morphine was significantly longer in the TEA group. No patients in the TEA group required postoperative morphine, whereas 88.2% and 47.1% required morphine in the SAPB and ESPB groups, respectively, p < 0.001. In the TEA group, intraoperative MAP values were lower than the other two groups, p < 0.05.ConclusionsErector spinae plane block can be used as an effective and safe alternative to thoracic epidural analgesia and shows superior analgesic profile to serratus anterior plane block for patients with lung cancer undergoing posterolateral thoracotomy.Copyright © 2021 Elsevier Inc. All rights reserved.

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