Effects of ultrasound-guided erector spinae plane block on postoperative analgesia and plasma cytokine levels after uniportal VATS: a prospective randomized controlled trial

Purpose Although uniportal video-assisted thoracoscopic surgery (VATS) has been widely used, the associated postoperative pain is still severe. Currently, a variety of regional anesthesia methods have been used to relieve postoperative pain. In our study, we wanted to evaluate the effectiveness of ultrasound-guided erector spinae plane block (ESPB) as a postoperative analgesia after uniportal VATS. Methods Eighty patients scheduled to undergo uniportal VATS were randomly divided into Group ESP and Group C. In Group ESP, the patients underwent ultrasound-guided ESPB under general anesthesia before surgery, while Group C was set as blank control group without ESPB. The primary outcome was the sufentanil dose within 24 h after surgery. The secondary outcomes mainly included postoperative pain scores at 2, 4, 8, and 24 h evaluated using a numeric rating scale (NRS), intraoperative opioid dosage, levels of inflammatory cytokines, including tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-10 (IL-10) in the plasma, side effect profile, and length of postoperative hospital stay. Results Postoperative sufentanil consumption (32.5 +/- 6.3 mu g vs. 42.8 +/- 7.6 mu g,P < 0.001) was significantly lower in Group ESP than in Group C. Intraoperative sufentanil consumption was significantly lower in Group ESP than in Group C (P < 0.001). The postoperative NRS score and levels of inflammatory cytokines were significantly lower in Group ESP than in Group C (P < 0.05). Conclusions Ultrasound-guided ESPB decreased the consumption of sufentanil both postoperatively and intraoperatively for patients undergoing uniportal VATS and appeared to be an effective treatment option.

Automated summary

Ultrasound-guided erector spinae plane block (ESPB) reduced the consumption of sufentanil in both postoperative and intraoperative periods for patients undergoing uniportal VATS, indicating it may be an effective treatment option.