A Randomized Trial to Compare Serratus Anterior Plane Block and Erector Spinae Plane Block for Pain Management Following Thoracoscopic Surgery

Abstract

Objective: Comparison of ultrasound (US)-guided erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) in video-assisted thoracic surgery (VATS) patients. The primary outcome was to compare perioperative and postoperative (48 hours) opioid consumption.

Methods: A total of 60 patients were randomized into two groups (N = 30): an ESPB group and an SAPB group. All the patients received intravenous patient-controlled postoperative analgesia and ibuprofen 400 mg intravenously every eight hours. Visual analog scale (VAS) scores, opioid consumption, and adverse events were recorded.

Results: Intraoperative and postoperative opioid consumption at 0-8, 8-16, and 16-24 hours and rescue analgesic use were significantly lower in the ESPB group (P < 0.05). Static/dynamic VAS scores were significantly lower in the ESPB group (P < 0.05). There was no significant difference between static VAS scores at the fourth hour. There were no differences between adverse effects. Block procedure time and one-time puncture success were similar between groups (P > 0.05 each).

Conclusion: US-guided ESPB may provide better pain control than SAPB after VATS.

Question: Even though there are studies about analgesia management after VATS, clinicians want to perform the technique that is both less invasive and more effective.

Findings: This randomized trial showed that US-guided ESPB provides effective analgesia compared with SAPB.

Meaning: Performing single-injection ESPB reduces VAS scores and opioid consumption compared with SAPB.

Keywords: Erector Spinae Plane Block; Postoperative Analgesia; Serratus Anterior Plane Block; Video-Assisted Thoracic Surgery.