Background A recent trend in postoperative analgesia for lung cancer surgery relies on regional nerve blocks with decreased opioid administration. Our study aims to critically assess the continuous ultrasound-guided erector spinae plane block (ESPB) at our institution and compare it to a standard regional anesthetic technique, the intercostal nerve block (ICNB). Patients and methods A prospective randomized-control study was performed to compare outcomes of patients, scheduled for video-assisted thoracoscopic (VATS) lung cancer resection, allocated to the ESPB or ICNB group. Primary outcomes were total opioid consumption and subjective pain scores at rest and cough each hour in 48 h after surgery. The secondary outcome was respiratory muscle strength, measured by maximal inspiratory and expiratory pressures (MIP/MEP) after 24 h and 48 h. Results 60 patients met the inclusion criteria, half ESPB. Total opioid consumption in the first 48 h was 21. 64 ± 14.22 mg in the ESPB group and 38.34 ± 29.91 mg in the ICNB group (p = 0.035). The patients in the ESPB group had lower numerical rating scores at rest than in the ICNB group (1.19 ± 0.73 vs. 1.77 ± 1.01, p = 0.039). There were no significant differences in MIP/MEP decrease from baseline after 24 h (MIP p = 0.088, MEP p = 0.182) or 48 h (MIP p = 0.110, MEP p = 0.645), time to chest tube removal or hospital discharge between the two groups. Conclusions In the first 48 h after surgery, patients with continuous ESPB required fewer opioids and reported less pain than patients with ICNB. There were no differences regarding respiratory muscle strength, postoperative complications, and time to hospital discharge. In addition, continuous ESPB demanded more surveillance than ICNB.

中文翻译：

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竖脊肌平面阻滞与肋间神经阻滞用于肺癌术后镇痛

背景 肺癌手术术后镇痛的最新趋势依赖于区域神经阻滞并减少阿片类药物的使用。我们的研究旨在严格评估连续超声引导竖脊肌我们机构的平面阻滞 (ESPB) 并将其与标准区域麻醉技术肋间神经阻滞 (ICNB) 进行比较。患者和方法进行了一项前瞻性随机对照研究，以比较分配到 ESPB 或 ICNB 组、计划接受电视胸腔镜 (VATS) 肺癌切除术的患者的结果。主要结果是阿片类药物的总消耗量以及术后 48 小时内每小时休息和咳嗽时的主观疼痛评分。次要结果是呼吸肌力量，通过 24 小时和 48 小时后的最大吸气压和呼气压 (MIP/MEP) 进行测量。结果 60 例患者符合纳入标准，一半为 ESPB。ESPB 组前 48 小时的阿片类药物总消耗量为 21. 64 ± 14.22 mg，ICNB 组为 38.34 ± 29.91 mg (p = 0.035)。ESPB 组患者静息时的评分数值低于 ICNB 组（1.19 ± 0.73）与1.77 ± 1.01，p = 0.039）。24 小时（MIP p = 0.088，MEP p = 0.182）或 48 小时（MIP p = 0.110，MEP p = 0.645）后、拔除胸管或出院的时间后，MIP/MEP 相对于基线的下降没有显着差异。两组。结论 在术后 48 小时内，持续 ESPB 患者比 ICNB 患者需要更少的阿片类药物，并且报告的疼痛也更少。呼吸肌力量、术后并发症和出院时间没有差异。此外，持续的 ESPB 比 ICNB 需要更多的监控。