Ultrasound-guided single erector spinae plane block versus thoracic paravertebral block for patients undergoing video-assisted thoracoscopic lobectomy: a single center randomized controlled trial

Abstract Background: Whether ultrasound-guided erector spinae plane block (ESPB) can replace thoracic paravertebral block (TPVB) remains unknown. This study aimed to determine the efficacy of ESPB compared with TPVB for postoperative analgesia after video-assisted thoracoscopic lobectomy under general anesthesia. Methods: This prospective randomized controlled trial divided patients into a control group, a TPVB group (0.3 mL/kg, 0.5% ropivacaine), and an ESPB group (0.5 mL/kg, 0.5% ropivacaine). Dermatomes with loss of pinprick sensation, were recorded during 30 min after block administration. Visual analog scale (VAS) scores, total analgesic dose, and complications after surgery were recorded. Results: Whether at rest or during coughing, the VAS scores were lower in ESPB group at 1, 6, 18, 24, and 48 h after surgery compared with the Control group. VAS scores were similar in the ESPB and TPVB groups at 1 h, but were lower in the ESPB group at 6, 18, 24, and 48 h postoperatively. Conclusions: Single ESPB provided superior postoperative analgesia than TPVB, without causing any adverse effect.