The Effects of Three Different Ultrasound-guided Nerve Blocks in VATS

The Effects of Ultrasound-guided Mid-point Transverse Process to Pleura Block, Erector Spinae Plane Block and Paravertebral Block on Postoperative Pain in Video-assisted Thoracic Surgery

Ultrasound-guided mid-point transverse process to pleura block, erector spinae plane block and paravertebral block are three different methods of nerve block, used for relieving postoperative pain in thoracic anesthesia. This study is to compare them on block effects, postoperative pain and analgesic consumption in video-assisted thoracic surgery.

Ultrasound-guided nerve block is an important part of multi-mode analgesia to decrease the consumption of opioids. Thoracic paravertebral block is considered as an ideal regional analgesic choice for video-assisted thoracic surgery, but it still has some side effects, such as pneumothorax, vascular injury, especially for novices. Recent years, ultrasound-guided mid-point transverse process to pleura block and erector spinae plane block are reported for thoracic surgery. The insertion depth in these two methods is more superficial than traditional paravertebral block. They could have less side effects. Therefore, we design a randomised control study to compare them on block effects, postoperative pain and analgesic consumption in video-assisted thoracic surgery.

Inclusion Criteria:

• selective lobetomy under VATS
• ASA classfication 1-3

Exclusion Criteria:

• history of thoracic surgery
• double lateral VATS
• allergy to local anesthetics
• coagulation disorders
• severe heart diseases, hepatic or renal insufficiency
• a history of chronic pain or chronic opioid use
• psychiatric disease or uncooperative
• BMI>28 kg/m2
• VATS transfered to open thoractomy