Comparison of Analgesic Effect and Postoperative Recovery of SAPB Combined With ESPB and TPB After Thoracoscopic Surgery

Comparison of Analgesic Effect and Postoperative Recovery of Serratus Anterior Plane Block Combined With Erector Spinae Plane Block and Thoracic Paravertebral Block After Thoracoscopic Surgery

After thoracoscopic surgery, patients still face moderate to severe pain. How to effectively control pain and promote postoperative recovery of patients is a challenging problem. Thoracic paraspinal block is effective in controlling pain after thoracoscopic surgery, but it also carries the risk of difficulty in operation and puncture of the pleura. In recent years, erector spinal plane block and serratus anterior plane block have been used for postoperative analgesia after thoracoscopic surgery. The purpose of this study was to explore whether erector spinal plane combined with serratus anterior plane block can replace thoracic paravertebral block and provide a more complete analgesia after thoracoscopic surgery. Therefore, this study is of great clinical significance.

In a double-blind randomized controlled study, investigators allocated 92 patients undergoing VATS to either SAPB Combined With ESPB or TPB, with both groups receiving otherwise standardized treatment, including multimodal analgesia. The primary outcome was 24-hr opioid consumption. Secondary outcomes included the number of survival analgesia at 1, 2, 4, 8, and 24 hours postoperatively ,VAS scores was assessed during resting and coughing statuses at 1, 2, 4, 8, and 24 hours postoperatively, pulmonary function indexes before and 1, 4, 24 hours after surgery , QOR-15 scores before and 24 hours after surgery, postoperative complications and recovery time nodes drainage tube removal time, discharge time.

Inclusion Criteria:

1. American ASA Grade I-III;
2. Age: 18 ~ 70 years old;

3 BMI 19 ~ 28kg/m2;

4. Patients with elective thoracoscopic partial pneumonectomy under general anesthesia;

5 Informed Consent has been signed.

Exclusion Criteria:

1. Use opioid analgesics on a daily basis or have a history of opioid abuse;
2. History of ipsilateral thoracotomy;
3. Allergic to any of the drugs used in the study, or have a history of drug allergy;
4. Mental or nervous system diseases, motor or sensory deficits;

5 there is coagulation dysfunction;

6. Cognitive dysfunction, unable to cooperate with research;

7. Severe renal, hepatic or cardiac dysfunction;

8. Chest wall and spine trauma, infection, deformity and other cases where nerve block cannot be performed;

9. Participated in other clinical trials within the 3 months prior to study inclusion;

10. Investigators consider other reasons unsuitable for clinical trial participants;

11. Patients refuse to participate.