• Yasuko Taketa, Yuki Takayanagi, Yumi Irisawa, and Taro Fujitani.
• From the Department of Anaesthesiology and Critical Care, Ehime Prefectural Central Hospital, Matsuyama City, Japan (YT, YT, YI, TF).
• Eur J Anaesthesiol. 2023 Feb 1; 40 (2): 130137130-137.

BackgroundThe optimal form of administration for erector spinae plane block has not been established.ObjectiveTo compare the efficacy of programmed intermittent bolus infusion (PIB) and continuous infusion for erector spinae plane block.DesignA prospective, randomised, double-blind study.SettingA single centre between June 2019 and March 2020.PatientsIncluded patients had an American Society of Anesthesiologists physical status 1 to 3 and were scheduled for video-assisted thoracic surgery.InterventionsPatients were randomised to receive continuous infusion (0.2% ropivacaine 8 ml h-1; Group C) or PIB (0.2% ropivacaine 8 ml every 2 h; Group P).Main Outcome MeasuresThe primary outcome was the number of desensitised dermatomes in the midclavicular line, measured 21 h after first bolus injection.ResultsFifty patients were randomly assigned to each group; finally, the data of 24 and 25 patients in Group C and P, respectively, were analysed. The mean difference in the number of desensitised dermatomes in the midclavicular line at 5 and 21 h after the initial bolus administration was 1.0 [95% confidence interval (CI) 0.5 to 1.5] and 1.6 (95% CI 1.1 to 2.0), respectively, which was significantly higher in Group P than in Group C (P < 0.001). The median difference in rescue morphine consumption in the early postoperative period (0 to 24 h) was 4 (95% CI 1 to 8) mg, which was significantly lower in Group P (P = 0.035). No significant difference in the postoperative numerical rating scale score was found between the groups.ConclusionsPIB for erector spinae plane block in video-assisted thoracic surgery resulted in a larger anaesthetised area and required a lower anaesthetic dose to maintain the analgesic effect. Therefore, it is more suitable for erector spinae plane block than continuous infusion.Trial RegistrationUMIN Clinical Trials Registry (UMIN-CTR, ID: UMIN000036574, Principal investigator: Taro Fujitani, 04/22/2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000041671).Copyright © 2022 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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