Analgesic efficacy of erector spinae plane block in thorascoscopic lung surgery: case series

Introduction Video assisted thoracoscopic surgeries (VATS) as well as thoracotomies require multimodal analgesia. Erector spinae plane block (ESPB) is newly introduced and showed adequate analgesia after VATS (1). In this report, we aimed to investigate the analgesic efficacy of the ESPB in thoracoscopic surgeries. Methods Written informed consent was obtained from all patients (for use of images and information) in this report. Patients (ASA I to III) above 18 years undergoing VATS were enrolled. Prior to anesthesia induction, we performed unilateral, single-injection ESPB at the level of T5 with USG guidance (figure 1). We used 20mL of 0.5% bupivakain. Multimodal analgesia comprised morphine via patient controlled analgesia, NSAID and paracetamol. Postoperative pain was questioned at 1st, 4th, 12th, 24th, 36th, and 48th hours (at rest and cough) using visual analog scale (VAS). Morphine consumption, additional analgesic (tramadol 0.5 mg/kg) requirement were enrolled as well as complications, mobilization and feeding times. Results This case series consisted of 3 female and 10 male patients with a mean age of 57±7. Four of them underwent lobectomy and resting 9 segmentectomy. VAS values (at rest and cough) are summarized in table 1. Mean morphine consumption for 12th and 24th hours were respectively 27.7±5.5mg and 48.2±13.6mg. Eleven of study patients needed once additional analgesic at 5±2.4 hours. Mobilization time was postoperatively at 4.7±0.98 hours and feeding at 5.11±0.92 hours. There was no complication among patients. Discussion ESPB is a simple and safe block with USG and systemic complications are rare. We think that ESPB is a suitable and reliable option at rest; meanwhile multimodal analgesia is still essential to ensure adequate analgesia for dynamic pain control after VATS.