Comparison of postoperative clinical effects of erector spinae plane block and patient controlled analgesia in thoracotomy patients

Objectives: The aim of this course is to compare Erector Spinae Plane (ESP) block and Patient Controlled Analgesia (PCA) methods for postoperative analgesia in patients undergoing thoracotomy surgery in terms of clinical efficacy and complication. Materials and Methods: The study included 80 patients who had thoracotomy surgery, 40 of whom had ESP block (Group E) and 40 of whom had HKA (Group H). Demographic data (age, gender, ASA score, height, weight, body mass index (BMI) and smoking status) were recorded. In Group E patients, ESP block was administered with 20 ml of 0,5% bupivacaine accompanied by ultrasound, patients in Group H were administered 10 µg/ml of fentanyl with 2,0 ml/h baseline and 2,0 ml bolus doses with a 15 minute lock-up period. The VAS and NRS scores of the groups, the time of the first additional analgesia, the total amount of additional analgesia consumed, and the side effects (nausea-vomiting, itching, respiratory depression, sedation, constipation) were recorded. Results: There was no difference between the two groups in terms of demographic data (p>0,05). The VAS and NRS scores were significantly lower in Group E than in Group H (p<0,05). The duration of initial analgesia demand in Group E was longer than in Group H and the total amount of opioids consumed was significantly lower in Group E (p<0,05). The incidence of nausea-vomiting and itching was significantly lower in Group E than in Group H (p<0,05). Discussion and Conclusion: Since thorax surgery causes significant pain, proper analgesia is important for both humanitarian reasons and to allow early mobilization and pulmonary rehabilitation. Poor painkillers can increase pulmonary complications and mortality. Therefore, there are many alternative analgesia methods besides ESP block, such as systemic opioid and nonopioid drug, thoracic epidural analgesia, intercostal block, paravertebral block, wound infiltration. ESP block application is more prominent than other methods because it has less effect on hemodynamics, and the technique is easier and safer. Based on our study,we also believe that the ESP block method is a more effective analgesia alternative since the ESP block performed for postoperative analgesia in patients undergoing thoracotomy surgery provides lower VAS values and lower opioid consumption with minor side effect profile in comparison to PCA. Keywords: Erector Spinae Plane Block, Patient Controlled Analgesia, Postoperative Analgesia, Thoracotomy