Postoperative Pain
Conditions
Brief summary
This study compared the postoperative analgesic efficacy of ultrasound-guided erector spinae plane (ESP) block and retrolaminar block in patients undergoing video-assisted thoracoscopic surgery (VATS). Adult patients were randomly assigned to receive either an ESP block or a retrolaminar block after induction of general anesthesia. Postoperative pain intensity was assessed using the Numeric Rating Scale (NRS) at predefined time points. Postoperative analgesic requirements and intraoperative opioid consumption were also evaluated.
Detailed description
This prospective, randomized study was conducted in adult patients undergoing video-assisted thoracoscopic surgery (VATS) under general anesthesia. Participants were randomly assigned to receive either an ultrasound-guided erector spinae plane (ESP) block or an ultrasound-guided retrolaminar block after induction of general anesthesia. The primary objective was to compare postoperative pain intensity between the two regional analgesic techniques. Pain intensity was assessed using the Numeric Rating Scale (NRS) at 1, 6, 12, and 24 hours after surgery. Additional outcomes included postoperative analgesic requirements, intraoperative remifentanil consumption, postoperative nausea and vomiting, and procedural characteristics of the blocks. Postoperative pain assessment was performed by an investigator blinded to group allocation. The clinician responsible for determining the need for rescue analgesia was also unaware of the assigned block technique.
Interventions
PROCEDUREErector spinae plane block (ESP)
An ultrasound-guided erector spinae plane block was performed after induction of general anesthesia. The block was administered as a regional analgesic technique in patients undergoing video-assisted thoracoscopic surgery.
PROCEDURERetrolaminar block group
An ultrasound-guided retrolaminar block was performed after induction of general anesthesia. The block was administered as a regional analgesic technique in patients undergoing video-assisted thoracoscopic surgery.
Sponsors
Hacettepe University
Gulhane Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
The investigator responsible for postoperative pain assessment using the Numeric Rating Scale (NRS) was blinded to group allocation. The clinician responsible for determining the need for rescue analgesia was also unaware of the assigned block technique. The anesthesiologist performing the block was not blinded due to the nature of the intervention
Eligibility
Sex/Gender
ALL
Age
18 Years to 81 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 81 years * American Society of Anesthesiologists (ASA) physical status I or II * Scheduled to undergo video-assisted thoracoscopic surgery (VATS) * Provided written informed consent to participate in the study
Exclusion criteria
* ASA physical status III or higher * Decompensated organ failure * Pregnancy * Known allergy or hypersensitivity to local anesthetics * Withdrawal of consent or request to discontinue participation in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Intensity Assessed Using the 11-Point Numeric Rating Scale | 1, 6, 12, and 24 hours after surgery | Postoperative pain intensity was assessed using the 11-point Numeric Rating Scale, ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pain intensity and therefore a worse outcome. Pain scores were recorded at 1, 6, 12, and 24 hours after surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Analgesic Requirement | Within the first 24 hours after surgery | The requirement for additional postoperative analgesic medication was recorded and compared between the erector spinae plane block and retrolaminar block groups. |
| Intraoperative Remifentanil Consumption | From induction of anesthesia until the end of surgery | Total intraoperative remifentanil consumption was recorded for each participant and compared between the two groups. |
| Postoperative Nausea and Vomiting (PONV) | Within the first 24 hours after surgery | The occurrence of postoperative nausea and vomiting was recorded for each participant and compared between the two groups. |
| Number of Block Attempts | During block performance procedure | The number of attempts required to successfully perform the assigned regional block was recorded for each participant. |
Countries
Turkey (Türkiye)
Outcome results
None listed