الفهرس | Only 14 pages are availabe for public view |
Abstract Abstract: Background: Regional block is advocated to reduce postoperative opioid consumption. Therefore, we aimed to compare the analgesic efficacy of Erector Spinae Plane Block (ESPB) and Thoracic Paravertebral Block (TPVB) after VATS on postoperative morphine requirement. Patients and method: This prospective, randomized, double-blinded trial was conducted on 80 consecutive adult patients who underwent VATS. Patients were randomly divided into 2 equal groups: receiving ESPB or TPVB before surgery. Both ultrasound-guided blocks were performed with an injection of 20 mL of 0.25% bupivacaine before anesthesia induction. The primary outcome was cumulative postoperative morphine consumption in the first 48 hr postoperatively. Results: The findings revealed that TPVB and ESPB groups were equivalent in analgesic efficacy with postoperative morphine consumption in mg 15.2±2.7 and 14.9±2.4 respectively. statistically significant shorter block time in ESPB was 8.1±1.7 minutes in contrast to 11.35±1.7 minutes in TPVB and better patient satisfaction in the ESPB than in TPVB groups (p-value < 0.05). Moreover, there were no statistically significant differences between groups regarding postoperative pain score (VAS) at rest and cough at any time point or incidence of complications between groups (p-value >0.05). There were significantly lower HR and BP trends in 15 and 30 minutes intraoperatively (p-value <0.001) in the TPVB group. Conclusion: ESPB has analgesic efficacy equivalent to TPVB from aspects of equivalent postoperative morphine consumption and VAS at rest and during cough with shorter block time and better patient satisfaction. |