Abstract
Background and objectivesThoracotomy is considered the most painful of surgical procedures and providing adequate analgesia is the onus for all anaesthesiologists. This study investigated the efficacy of the ultrasound-guided erector spinae plane (ESP) block in analgesia after thoracotomies.Patients and methodsSixty patients with American Society of Anesthesiology physical status (ASA-PS) I–IV, aged more than 18 years were allocated to two groups, ESP group which received the ESP block and C (control) group with no block. Single-shot U/S-guided ESP block with 20 ml 0.25% bupivacaine at the 5th thoracic vertebral level was performed preoperatively in the ESP group. Postoperative 24 h morphine consumption and pain scores were compared between the groups. Also, the side effects of opioid usage were compared.Main resultsPostoperative morphine consumption was 22.06 ± 6.24 mg in the ESP group and 30.6 ± 6.23 mg in the C group (p < 0.001). Results showed that there was a significant difference between both groups in favour of the ESP group regarding visual analogue score (VAS) at rest and with coughing (p < 0.001).ConclusionOur study findings show that US-guided ESP block exhibits a significant analgesic effect in patients undergoing thoracotomy surgery.Trial registrationClinicalTrials.gov, NCT03749395. Registered 13 November 2018
Highlights
Thoracotomy is considered one of the most painful of surgical procedures, and providing effective analgesia is the responsibility for all anaesthesiologists
Our study findings show that US-guided erector spinae plane (ESP) block exhibits a significant analgesic effect in patients undergoing thoracotomy surgery
visual analogue score (VAS) score during rest (VASR) Regarding VAS scores obtained during rest (VASR) in both groups which monitored at 0 times, 6, 12, 18, and 24 h postoperative, we found that there were significant differences in favour of ESP group with p value < 0.04 at 0 times and p value < 0.001 at the other times
Summary
Thoracotomy is considered one of the most painful of surgical procedures, and providing effective analgesia is the responsibility for all anaesthesiologists. Thoracic epidural analgesia (TEA) and thoracic paravertebral block (TPVB) are currently the recommended first-line techniques for use in post-thoracotomy pain management. They can be technically challenging to perform and are associated with a significant failure rate (up to 15% in TEA) (Romero et al 2013). Thoracotomy is considered the most painful of surgical procedures and providing adequate analgesia is the onus for all anaesthesiologists. Postoperative 24 h morphine consumption and pain scores were compared between the groups.
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