Introduction: We conducted a comparative study to evaluate analgesic efficacy between continuous thoracic epidural analgesia (TEA) and erector spinae plane (ESP) block in patients with lung cancer undergoing video-assisted thoracic surgery (VATS).
Methods: A prospective, randomized, double-blinded study was conducted in lung cancer patients scheduled for VATS lobectomy, segmentectomy, and wedge resection. A total of 39 patients were randomly allocated to receive either continuous TEA or ESP block (Group E; TEA, Group ES; ESP block). Postoperative pain was assessed using a numerical rating scale (NRS) score at 1h, 3h, 6h, 12h, 24h, and 48h during rest and cough. Time to first rescue drug injection, total rescue drug consumption, incidence of adverse effect and patient’s satisfaction were also evaluated.
Results: There were no significant differences between groups in demographic data and surgical characteristics. There were no significant differences between groups regarding procedural time, dermatomal range of sensory threshold after 1h ropivacaine loading injection. Both groups were comparable with NRS scores at 1h, 3h, 6h, 12h, 24h, and 48h during rest and cough (p > 0.05). But, the Group E had statistically significant higher incidence of adverse effect, such as nausea, dizziness, than Group ES. There were no statistically significant differences between groups in patient’s satisfaction for block, postoperative pain management, and adverse effect.
Conclusions: Continuous ESP had a comparative pain score with TEA, reducing adverse effect, such as nausea, dizziness. Therefore, it can be an effective alternative to TEA in patients undergoing VATS.