Comparison of Thoracic Epidural Block Versus Erector Spinae Plane Block for Post-Operative Pain Relief in Thoracotomies

Objective: To Compare post-operative analgesic effectiveness of thoracic epidural block with erector spinae plane block in patients with thoracotomies. Study Design: Randomized Controlled Trial (IRCT20231113060036N1). Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Rawalpindi Pakistan, from Jul to Dec 2023. Methodology: The patients were divided into the thoracic epidural block group (Group-T) (n=20) and the erector spinae block group (Group-E) (n=20). Primary variables measured were mean time to first rescue analgesia, total dose of intravenous analgesia needed in 24 hours and median pain scores at 1, 3, 6, 12 and 24 hours and patient satisfaction for pain relief on the Likert scale 24 hours after intervention. Results: Mean time for first dose of added rescue analgesia was 178.15±10.51 minutes in Group-T versus 320.35±15.23 minutes in Group-E (p<0.001). Total added intravenous analgesia post-surgery in 24 hours was 14.45±1.09 mg in Group-T versus 10.15±1.26 mg in Group-E (p<0.001). When assessed after 3-hours post-surgery, median scores were 5.00 (IQR=0.00) in Group-T versus 3.00 (IQR=0.00) in Group-E (p<0.001). Conclusion: The Erector Spinae Plain Block provides effective and comparable analgesia compared to Thoracic Epidural Block with less opioid requirement and a better adverse effect profile.