B111 Comparison of postoperative morphine consumption of ultrasound (US) guided erector spinae plane block (ESPB) and paravertebral block (TPVB) in thoracotomy surgery patients

Background and Aims

Thoracotomy is associated with severe postoperative pain (1). According to several studies, paravertebral block (PVB) provides effective analgesia similar to epidural analgesia, and has a less side-effect profile (2). Recently erector spinae plane block (ESPB) has been shown to be an easier and safer alternative to PVB(3). The primary aim of this study was to compare post-thoracotomy opioid consumption between PVB and ESPB.

Methods

After the approval of the local ethical committee, patients aged between 18 and 75 years with an American Society of Anesthesia (ASA) physical status I-III, and scheduled for elective thoracotomy were included in the study. Patients were divided into two groups to receive either ESPB or PVB. All patients were provided with PCA device preloaded with morphine. Postoperative 24 hour morphine consumptions were recorded.

Results

Data from 45 patients were used in the final analyses. Morphine consumption was higher in the ESP group than in the PVB group at 24 hours postoperatively. (19.2 ± 4.26 mg and 16.2± 2,64 mg respectively).

Conclusions

In the light of the results of this study, even there is a statistically significant difference on morphine consumpitons, clinically ESPB could provide similar postoperative analgesia to PVB in thoracotomy surgeries. In addition, the significant distance from the pleura and vascular structures while performing ESPB and the presence of the transverse process as a barrier reduces the possibility of complications. We think that ESPB can be an alternative to PVB, as a part of multimodal analgesia for post thoracotomy pain.