Comparative efficacy of erector spinae plane block versus surgeon-performed intraoperative intercostal nerve block in video-assisted thoracoscopic surgery: a retrospective analysis.

IF 1.8 3区医学 Q2 SURGERY

BMC Surgery Pub Date : 2025-10-09 DOI:10.1186/s12893-025-03178-z

Soner Kına, Güntuğ Batıhan, Hüseyin Türkan, Yekta Bektaş

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Abstract

Background: Video-assisted thoracoscopic surgery (VATS) offers reduced postoperative pain and faster recovery, yet optimal analgesia remains essential. Regional anesthesia techniques, such as the erector spinae plane (ESP) block and intercostal nerve block (ICNB), are commonly employed. This study compares preoperative ESP block with surgeon-performed intraoperative ICNB in VATS patients.

Methods: In this retrospective study, 82 patients (≥ 18 years; ASA I-III) underwent elective VATS between January 2020 and December 2022 were analyzed. Forty patients received a postoperative ESP block and 42 an intraoperative ICNB. Primary outcomes included postoperative pain scores using the Visual Analog Scale, postoperative peak expiratory flow (PEF), postoperative IV opioid analgesic use, drainage time, and hospital length of stay.

Results: Baseline demographics were similar. VAS scores were comparable at postoperative 1, 3, 6, 12 and 24 h. At postoperative 48 h, the ICNB group had significantly lower VAS scores (4.17 ± 1.03 vs. 4.78 ± 1.03; p = 0.00987). No significant differences were observed in postoperative iv opioid analgesic use, drainage time or hospital stay.

Conclusions: Both techniques provide effective early analgesia in VATS, with ICNB showing prolonged pain relief. Further prospective studies are warranted.

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竖脊肌平面阻滞与外科手术术中肋间神经阻滞在电视胸腔镜手术中的疗效比较：回顾性分析。

背景：视频辅助胸腔镜手术（VATS）可以减少术后疼痛和更快的恢复，但最佳镇痛仍然是必不可少的。区域麻醉技术，如竖脊面阻滞（ESP）和肋间神经阻滞（ICNB），是常用的麻醉方法。本研究比较了VATS患者术前ESP阻滞与术中ICNB。方法：在这项回顾性研究中，分析了2020年1月至2022年12月期间接受选择性VATS的82例患者（≥18岁；ASA I-III）。40例患者术后接受ESP阻滞，42例患者术中接受ICNB。主要结局包括术后疼痛评分（视觉模拟量表）、术后呼气峰流量（PEF）、术后静脉注射阿片类镇痛药的使用、引流时间和住院时间。结果：基线人口统计学相似。术后1、3、6、12、24 h的VAS评分具有可比性。术后48 h， ICNB组VAS评分显著低于对照组（4.17±1.03∶4.78±1.03;p = 0.00987）。术后静脉阿片类镇痛药的使用、引流时间和住院时间均无显著差异。结论：两种技术均可提供有效的VATS早期镇痛，ICNB可延长疼痛缓解时间。进一步的前瞻性研究是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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