학술논문

Effects of continuous erector spinae plane block on postoperative pain in video-assisted thoracoscopic surgery: a randomized controlled study
Document Type
Original Paper
Source
General Thoracic and Cardiovascular Surgery. 70(1):64-71
Subject
Analgesia
Patient-controlled
Analgesics
Opioid
Intermediate back muscles
Nerve block
Pain
Postoperative
Paraspinal muscles
Thoracic surgery
Video-assisted
Tramadol
Ultrasonography
Language
English
ISSN
1863-6705
1863-6713
Abstract
Background: The aim of this prospective, randomized, controlled study was to evaluate the analgesic effect of ultrasonography (USG) guided continuous erector spinae plane block (ESPB) for postoperative analgesia in video-assisted thoracoscopic surgery (VATS).Methods: Eighty American Society of Anesthesiologists (ASA) physical status I-III patients aged 18–75 and who were to undergo VATS were included in this study. Randomization was performed in 2 groups, continuous ESPB (ESPB Group) and no intervention (Control Group). 20 mL of 0.25% bupivacaine was administered for the block. Immediately after surgery, the patient received continuous infusion of 0.125% bupivacaine at 4 mL h−1 via the catheter inserted for the block. Patients in both groups received tramadol via an intravenous patient-controlled analgesia device. Tramadol and meperidine consumption, visual analog scale pain scores and opioid-related side effects were recorded at 0, 1, 4, 8, 12, 24, 36, and 48 h postoperatively.Results: The use of continuous ESPB in VATS significantly decreased the amount of tramadol used in the first 48 h postoperatively (P < 0.001). There was a statistically significant difference in the number of meperidine rescue analgesia administered between the ESPB and Control Groups (P < 0.001). While the incidences of nausea and itching were higher in Control Group, there were no differences in terms of the other side effects between the groups.Conclusions: This study shows that USG-guided continuous ESPB provides adequate analgesia following VATS as part of multimodal analgesia. Continuous ESPB significantly reduced opioid consumption and opioid-related side effects compared to those in the Control Group.