Comparison between serratus anterior plane block versus erector spinae plane block for postoperative analgesia after video-assisted thoracoscopic surgery (VATS)

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Abstract

Background
Video-assisted thoracoscopic surgery is a minimally invasive technique resulting in decrease levels of pain. However, to provide more effective pain control after VATS, this necessitates analgesia that inhibits somatic and visceral nerve fibers.
Aim of the study
Aim of the study is to compare SAPB or ESPB for postoperative analgesia following VATS, as determined by the time until the first analgesic requirement. Comparisons of adverse effects and total analgesic requirement in the first 24-hour post-operative were the secondary endpoints.
Patients and Methods
Forty patients participated in this prospective randomized clinical study. At the conclusion of surgery, 20 patients underwent a single-injection US-guided ESPB, and 20 patients underwent a SAPB after VATS. Inclusion Criteria: (ASA) 1–3. Exclusion criteria: Patients <20 or >80 years old, patients who refuse to take part in the research, patients have a history of medication allergies, contraindication to regional anesthesia, severe hepatic and renal dysfunction
Results
As regarding to demographic information, there were no significant changes between the two groups. Timing of the first analgesic requirement was statistically faster among SAPB Group (12.54 ± 6.46 h) compared to ESPB Group (18.29 ± 6.05 h). Postoperative pethidine required was significantly higher in SAPB group than in ESBP group [ESPB (35.71 ± 19.67 mg) < SAPB (63.08 ± 25.29 mg), with -value <0.05. No remarkable side effects were found in the two groups.
Conclusion
Both ESPB and SAPB can be used for pain control after VATS. Our study showed that US-directed ESPB offers more effective pain management than SAPB.

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Egyptian Journal of Anaesthesia
Volume 39, Issue 1
December 2023
Pages 440-445

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