Impact of ultrasound-guided erector spinae plane block on postoperative quality of recovery in video-assisted thoracic surgery: A prospective, randomized, controlled trial

• Published in: Journal of clinical anesthesia Vol. 63; p. 109783
• Main Authors: Yao, Yusheng, Fu, Shiwei, Dai, Shuangbo, Yun, Jia, Zeng, Minghui, Li, Hao, Zheng, Xiaochun
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2020; Elsevier Limited
• Subjects: Analgesics; Epidural; Erector spinae plane block; General anesthesia; Likert scale; Local anesthesia; Medical personnel; Ostomy; Pain; Pain management; Patient satisfaction; Quality of recovery; Recovery (Medical); Thoracic surgery; Ultrasonic imaging; Ultrasonography; Video-assisted thoracic surgery; United States > US; China; Quality of recovery; Erector spinae plane block; Video-assisted thoracic surgery; Ultrasonography; Pain management
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2020.109783

Regional anesthesia improves postoperative analgesia and enhances the quality of recovery (QoR) after surgery. We examine the efficacy of ultrasound-guided erector spinae plane block (ESPB) on QoR after video-assisted thoracic surgery (VATS). Prospective, randomized, double-blinded, placebo-controlled trial. Single institution, tertiary university hospital. Adult patients who scheduled for VATS under general anesthesia were enrolled in the study. We randomly allocated patients to receive preoperative ultrasound-guided ESPB with 25 ml of either 0.5% ropivacaine (ESPB group) or normal saline (Control group). The primary outcome was QoR as measured by the 40-item QoR questionnaire (QoR-40) score at postoperative day 1. Secondary results were post-anesthesia care unit (PACU) discharge time, acute postoperative pain, cumulative opioid consumption, the incidence of postoperative nausea or vomiting (PONV), and patient satisfaction. The global QoR-40 score at postoperative day 1 (median, interquartile range) was significantly higher in the ESPB group (174, 170 to 177) than the control group (161.5, 160 to 165), estimated median difference 11 (95% CI 9 to 13, P < 0.001). Compared with the control group, single-injection of ESPB reduced PACU discharge time, acute postoperative pain, and cumulative opioid consumption. Correspondingly, the median patient satisfaction scores were higher in the ESPB group than the control group (9 versus 7, P < 0.001). Preoperative single-injection thoracic ESPB with ropivacaine improves QoR, postoperative analgesia, and patient satisfaction after VATS. •Erector spinae plane block enhances the quality of recovery after video-assisted thoracic surgery.•Erector spinae plane block reduces postoperative pain and opioid consumption.•Erector spinae plane block improves patient satisfaction after video-assisted thoracic surgery.