Block and Erector Comparative Study Between Costotransverse Spinae Plane Block in Patients Undergoing Thoracotomy

Block and Erector Comparative Study Between Costotransverse Spinae Plane Block for Postoperative Analgesia in Patients Undergoing Thoracotomy

A thoracotomy requires a very painful incision, involving multiple muscle layers, rib resection and continuous motion as the patient breathes. Treatment of acute post thoracotomy pain is particularly important not only to keep the patient comfortable but also to minimize pulmonary complications

Though epidural analgesia was once considered as the gold standard for post-thoracotomy pain management, it is not recommended for pain control after thoracotomy surgery because it is associated with high potential risks of dural puncture, nerve lesions, epidural hematoma and hypotension(4). Thoracic paravertebral block (TPVB) and intercostal nerve block are well described and recognized techniques for postoperative analgesia following thoracic surgeries, such as thoracotomy and mastectomy

Inclusion Criteria:

• • Age from 18 to 75 years old.

  • Both sexes.
  • American Society of Anesthesiologists (ASA) physical status I-II-III.
  • Patient undergoing unilateral thoracotomy surgery.

Exclusion Criteria:

• • BMI more than 30 kg/m2.

  • Patients who are taking analgesics for chronic illness or have a history of substance abuse.
  • Patients who are unable to describe their postoperative pain (e.g., language barrier or neuropsychiatric disorder).
  • Patients with a history of coagulopathy.
  • Severe heart diseases.
  • Hepatic or renal insufficiency.
  • Infection at the site of infiltration