Comparison of postoperative efficacies of serratus anterior plane block and erector spinae plane block in patients undergoing video assisted thoracoscopic surgery

In our prospective and randomised study, we aimed to compare the effects of serratus anterior plane block (SAPB) and erector spinae plane block (ESPB) for postoperative analgesia in patients undergoing video assisted thoracoscopic surgery (VATS). After ethics committee approval and written consent from the patients, 70 patients aged 18-80 years, who would undergo elective VATS and were classified as American Society of Anesthesiologists (ASA) I-II, were included in the study. The demographic data of the patients were recorded and they were divided into two groups as SAPB (n=35) and ESPB (n=35) after routine monitoring and standard anesthesia induction. Patient-controlled analgesia (PCA) containing morphine was applied to the patients. The hemodynamic data of the patients were recorded before/after the induction and at intraoperative 30-minute periods. Intraoperative opioid consumption, duration of time in recovery room, Visual Analogue Scale (VAS) scores at rest and coughing, time to first PCA requirement, postoperative opioid consumptions, first requirement times and amounts of rescue analgesics, duration time until first mobilization, opioid side effects, length of hospital stay, patient and surgeon satisfaction was evaluated. In the ESPB group, the VAS scores at rest (0.min, 60.min, and 2.h) and coughing (0. min) were lower (p<0.05 for each variable) and the time to first PCA requirement was longer (p=0.001). Morphine consumption with postoperative PCA at 2., 4., 8. and 12. hour was lower in the ESPB group (p<0.005 for each variable). Other follow-up parameters and opioid-related side effects were similar. iv As a result, it was concluded that ESPB provided more effective and long-lasting analgesia than SAPB in VATS interventions, since the early postoperative VAS scores were lower, opioid consumption was lower, and the time to first analgesic requirement was longer in the ESPB group.