Continuous Erector Spinae Plane Block for Postoperative Analgesia in Elderly Patients After Thoracoscopic Lobectomy

Abstract

PurposeCompared the effect of ultrasound-guided continuous erector spinae plane block to continuous thoracic paravertebral block on postoperative analgesia in elderly patients underwent thoracoscopic lobectomy. DesignThe patients who underwent non-emergent thoracoscopic lobectomy in thoracic surgery department of our hospital from January 2019 to December 2020 were selected and randomly divided into continuous erector spinae block(ESPB) group and continuous thoracic paravertebral block(TPVB) group. MethodsFifty elderly patients with thoracoscopic lobectomy under general anesthesia from January 2019 to December 2020 were selected and randomly divided into continuous erector spinae block(ESPB) group and continuous thoracic paravertebral block(TPVB) group, with 25 patients in each group. The patients in the two groups were guided by ultrasound with ESPB or TPVB before anesthesia induction. The visual analog scale (VAS) at rest and cough in 2h, 6h, 8h, 12h, 24h, 48h after surgery, the supplementary analgesic dosage of tramadol, time of tube placement, the stay time in post-anesthesia care unit(PACU), the first ambulation time after surgery, the length of postoperative hospital stay and postoperative complications were recorded. FindingsThere were no significant differences between the two groups in VAS score at rest and cough at each time point and supplementary analgesic dosage of tramadol within 48h after surgery (p>0.05). The time of tube placement and the postoperative hospital stay in ESPB group was significantly shorter than that in TPVB group(p<0.05). There were no differences in PACU residence time and first ambulation time between the two groups(p>0.05). There were 4 patients in TPVB group and 2 patients in ESPB group occurred nausea and vomiting(P>0.05), 1 case of pneumothorax and 1 case of fever occurred in TPVB group. There were no incision infection or respiratory depression requiring clinical intervention occurred in both groups. ConclusionsBoth ESPB and TPVB alleviated the patients postoperative pain effectively for elderly patients underwent thoracoscopic lobectomy. Compared with TPVB, ESPB have shorter tube placement time, fewer complications and faster postoperative recovery. Unitsmg/kg, Milligram per kilogram; mL, Millilitres; ml/h, Millilitres per hour; ug/kg, Microgram per kilogram; ml/kg, Millilitres per kilogram; ml/kg/h, Millilitres per kilogram per hour; mg, Milligram. FootnotesNot applicable.