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.

中文翻译：

---

连续竖脊肌平面阻滞对电视胸腔镜手术术后疼痛的影响：一项随机对照研究

背景

这项前瞻性、随机、对照研究的目的是评估超声（USG）引导的连续竖脊肌平面阻滞（ESPB）在电视胸腔镜手术（VATS）术后镇痛中的镇痛效果。

方法

本研究包括 80 名美国麻醉医师协会 (ASA) 身体状况 I-III 的 18-75 岁且将接受 VATS 的患者。随机分为两组，连续 ESPB（ESPB 组）和无干预（对照组）。给予 20 mL 0.25% 布比卡因用于阻滞。手术后，患者立即通过插入用于阻滞的导管以 4 mL h ^-1连续输注 0.125% 布比卡因。两组患者均通过静脉自控镇痛装置接受曲马多治疗。在术后 0、1、4、8、12、24、36 和 48 小时记录曲马多和哌替啶的消耗量、视觉模拟量表疼痛评分和阿片类药物相关的副作用。

结果

在 VATS 中持续使用 ESPB 显着减少了术后前 48 小时使用的曲马多量（P < 0.001）。ESPB组和对照组的哌替啶解救镇痛次数差异有统计学意义（P < 0.001）。虽然对照组的恶心和瘙痒发生率较高，但两组之间的其他副作用没有差异。

结论

这项研究表明，作为多模式镇痛的一部分，USG 引导的连续 ESPB 可在 VATS 后提供足够的镇痛。与对照组相比，持续 ESPB 显着减少了阿片类药物的消耗和阿片类药物相关的副作用。