• Chun-Sung Sung, Tzu-Jung Wei, Jung-Jyh Hung, Fu-Wei Su, Shih-I Ho, Mong-Wei Lin, Kuang-Cheng Chan, and Chun-Yu Wu.
• Department of Anesthesiology, Taipei Veteran General Hospital, Taipei, Taiwan.
• J Clin Anesth. 2024 Aug 1; 95: 111448111448.

Study ObjectiveThis study aimed to compare the analgesic effects of anesthesiologist-administrated erector spinae plane block (ESPB) and surgeon-administrated intercostal nerve block (ICNB) following video-assisted thoracoscopic surgery (VATS).DesignRandomized, controlled, double-blinded study.SettingOperating room, postoperative recovery room and ward in two centers.PatientsOne hundred patients, ASA I-III and scheduled for elective VATS.InterventionsThe anesthesiologist-administrated ESPB under ultrasound guidance or surgeon-administrated ICNB under video-assisted thoracoscopy was randomly provided during VATS. Regular oral non-opioid analgesic combined with intravenous rescue morphine were prescribed for multimodal analgesia after surgery.MeasurementsThe primary outcomes were the pain score and morphine consumption during 48 h after surgery. Postoperative pain intensity were assessed using the 10-cm visual analogue scale at 1 h, 24 h, and 48 h after surgery. Morphine consumption at these time points was compared between the two study groups. Furthermore, oral weak opioid rescue analgesic was also provided at 24 h after surgery. Postoperative quality of recovery at 24 h was also assessed using the QoR-15 questionnaire, along with duration of chest tube drainage and hospital stay were compared as secondary outcomes.Main ResultsPatients in the two study groups had comparable baseline characteristics, and surgical types were also similar. Postoperative VAS changes at 1 h, 24 h, and 48 h after surgery were also comparable between the two study groups. Both groups had low median scores (<4.0) at all time points (all p > 0.05). Patients in the ESPB group required statistically non-significant higher 48-h morphine consumption [3 (0-6) vs. 0 (0-6) mg in the ESPB group and ICNB group respectively; p = 0.135] and lower numbers of oral rescue analgesic (0.4 ± 1.2 vs. 1.0 ± 1.8 in the ESPB group and ICNB group respectively; p = 0.059). Additionally, patients in the two study groups had similar QoR15 scores and lengths of hospital stay.ConclusionsBoth anesthesiologist-administered ultrasound-guided ESPB and surgeon-administered VATS ICNB were effective analgesic techniques for patients undergoing VATS for tumor resection.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

35 keywords...

hide…