• Saudi Med J · Feb 2023

    Randomized Controlled Trial

    A prospective double-blinded randomized control trial comparing erector spinae plane block to thoracic epidural analgesia for postoperative pain in video-assisted thoracic surgery.

    • Jeong-Min Hong, Eunsoo Kim, Soeun Jeon, Dowon Lee, Jiseok Baik, Ah-Reum Cho, Jeong Su Cho, and Hyo Yeong Ahn.
    • From the Department of Anesthesia and Pain Medicine (Hong, Kim, Jeon, Lee, Baik, A. R. Cho), School of Medicine, Pusan National University; from the Department of Anesthesia and Pain Medicine (Hong, Kim), Biomedical Research Institute, Pusan National University Hospital; from the Department of Thoracic and Cardiovascular Surgery (J. S. Cho, Ahn), Pusan National University Hospital, Busan; from the Department of Anesthesia and Pain Medicine (Jeon), School of Dentistry, Kyungpook National University, Daegu, Korea.
    • Saudi Med J. 2023 Feb 1; 44 (2): 155163155-163.

    ObjectivesTo compare the analgesic efficacies of erector spinae plane (ESP) block and thoracic epidural analgesia (TEA) in video-assisted thoracic surgery (VATS).MethodsSixty patients undergoing VATS received patient-controlled TEA with a basal rate of 3 ml/hour (h), a bolus of 3 ml (Group E), or ESP block with programmed intermittent bolus infusions of 15 mL/3 h and a bolus of 5 ml (Group ES) for 2 postoperative days. The primary outcome was to compare pain scores at rest 24 h postoperatively between the 2 groups. Secondary outcomes included NRS score for 48 h, procedural time, dermatomal spread, use of rescue medication, adverse events, and patient satisfaction.ResultsPatients with continuous ESP block had a higher NRS score than those with TEA but no statistical difference at a specific time. The dermatomal spread was more extensive in the TEA group than in the ESP block group (p=0.016); cumulative morphine consumption was higher in the ESP block group (p=0.047). The incidence of overall adverse events in the TEA group was higher than in the ESP block group (p=0.045).ConclusionErector spinae plane block may be inferior to TEA for analgesia following VATS, but it could have tolerable analgesia and a better side effect profile than TEA. Therefore, it could be an alternative to TEA as a component of multimodal analgesia.Copyright: © Saudi Medical Journal.

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