Comparative study between ultrasound guided serratus anterior plane block, thoracic erector spinae plane block and thoracic paravertebral block for postoperative analgesia in thoracotomy

Abstract

Background: Ultrasonography is frequently used in conjunction with a variety of blocks to reduce opioid use and postoperative pain after thoracotomy. The study compared SAPB, ESPB, and TPVB for postoperative pain relief in thoracotomy patients. It assessed the effectiveness of each technique in managing pain after surgery. Methods: This double-blind, randomized study included 90 patients, aged 21 to 65, undergoing thoracotomy. All participants were classified as ASA I or II. The study aimed to assess their clinical outcomes. Three equal groups of participants were chosen at random: Group 1: patients underwent US guided TPVB, Group 2: patients underwent US guided ESPB and Group 3: patients underwent SAPB. Results: No significant differences in VAS (Visual Analog Scale) scores were observed within the first six hours of observation. However, at the 12-hour and 24-hour marks, both Groups I and II exhibited lower VAS scores compared to Group III. By the 24-hour point, Group III demonstrated a significant reduction in both Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1) when compared to Groups I and II, indicating notable differences in respiratory function between the groups. Conclusions: ESPB is ideal and can be utilized as a secure and efficient substitute to TPVB due to it is easy to perform and has less block associated complication.