Comparison of postoperative analgesic efficacy of thoracic paravertebral block, erector spinae plane block and serratus posterior superior intercostal plane blocks performed under ultrasonographic guidance in video-assisted thoracoscopic surgery patients

INTRODUCTION AND AIM: Thoracic region plane blocks are widely used to provide postoperative analgesia in video-assisted thoracoscopic surgery (VATS). The aim of this study is to compare the postoperative analgesic effectiveness of thoracic paravertebral (TPV), erector spina plane (ESP), and serratus posterior superior intercostal plane (SPSIP) blocks, all performed under ultrasound guidance, in patients undergoing VATS. METHODS: Approval was obtained from the local ethics committee for this study. Medical records of patients who underwent VATS surgery between November 2023 and October 2024 were reviewed. Patients aged 18–65 years, classified as ASA I-III risk and who received TPV, ESP or SPSIP blocks were included in the study. Demographic data were collected from the patients' archived records. Postoperative opioid consumption in the first 24 hours, Numerical Rating Scale (NRS) scores, time to first analgesic requirement, and time to need for rescue analgesics were retrieved from the medical files. RESULTS: A total of 59 patients were identified, with 20 in the TPV block group, 20 in the ESP block group, and 19 in the SPSIP block group. There were no significant differences in fentanyl consumption or time to first analgesic requirement between the groups. Furthermore, no significant differences were found in the NRS scores at postoperative hours 0, 2, 4, 8, 16, and 24. The time to first analgesic requirement and need for rescue analgesia were also similar among the groups. CONCLUSION: In our study, we conclude that TPV, ESP, and SPSIP blocks, which were used for postoperative analgesia in VATS patients, were effective in providing adequate analgesia, with similar efficacy across the groups. We believe that each of these methods can be safely used as an alternative for postoperative analgesia in VATS procedures.