Abstract
Background & Aims:Thoracic epidural analgesia (TEA) was compared with erector spinae block (ESP) for postoperative pain management in patients undergoing thoracotomy.Methods:A prospective, randomised clinical study was conducted. 64 patients were enroled and randomised by simple randomsampling into either group A: TEA (n=32) or group B: ESP block (n=32). Both groups received standardised general anaesthesia and continuous infusion of 0.125% bupivacaine plus 2 µg per ml fentanyl at the rate of 5 ml/hour till 48 hours postextubation.The primary outcome was to compare Visual analogue scale (VAS) for postoperative pain. Secondary outcomes included peakinspiratory flow rates, ventilator stay duration, haemodynamic parameters, adverse effects, ICU stay.Statistical analysis was performed using independent Student’s t-test. p value of <0.05 was considered statistically significant.Results:Group A had statistically significant higher VAS score than B at 3,6,12,24 h post-extubation. Group B had higher peak inspiratory flow rates compared with group A at 3,6,12,24,36, 48 h respectively. Duration of ICU stay was longer in group A than B. Rescue analgesia usage was higher in group A compared to group B. No adverse effects were reported in both groups.Conclusion:ESP block is an efficacious alternative to TEA in providing better postoperative pain management with minimal ICU stay following open thoracic surgeries.
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