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Updated: Aug 15, 2025
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Programmed intermittent bolus infusion vs. continuous infusion for erector spinae plane block in video-assisted
Yasuko Taketa1, Yuki Takayanagi, Yumi Irisawa
1From the Department of Anaesthesiology and Critical Care, Ehime Prefectural Central Hospital, Matsuyama City, Japan (YT, YT, YI, TF).
Background:
The optimal form of administration for erector spinae plane block has not been established.
Objective:
To compare the efficacy of programmed intermittent bolus infusion (PIB) and continuous infusion for erector spinae plane block.
Design:
A prospective, randomised, double-blind study.
Setting:
A single centre between June 2019 and March 2020.
Patients:
Included patients had an American Society of Anesthesiologists physical status 1 to 3 and were scheduled for video-assisted thoracic surgery.
Interventions:
Patients were randomised to receive continuous infusion (0.2% ropivacaine 8 ml h-1; Group C) or PIB (0.2% ropivacaine 8 ml every 2 h; Group P).
Main Outcome Measures:
The primary outcome was the number of desensitised dermatomes in the midclavicular line, measured 21 h after first bolus injection.
Results:
Fifty patients were randomly assigned to each group; finally, the data of 24 and 25 patients in Group C and P, respectively, were analysed. The mean difference in the number of desensitised dermatomes in the midclavicular line at 5 and 21 h after the initial bolus administration was 1.0 [95% confidence interval (CI) 0.5 to 1.5] and 1.6 (95% CI 1.1 to 2.0), respectively, which was significantly higher in Group P than in Group C (P < 0.001). The median difference in rescue morphine consumption in the early postoperative period (0 to 24 h) was 4 (95% CI 1 to 8) mg, which was significantly lower in Group P (P = 0.035). No significant difference in the postoperative numerical rating scale score was found between the groups.
Conclusions:
PIB for erector spinae plane block in video-assisted thoracic surgery resulted in a larger anaesthetised area and required a lower anaesthetic dose to maintain the analgesic effect. Therefore, it is more suitable for erector spinae plane block than continuous infusion.
Trial Registration:
UMIN Clinical Trials Registry (UMIN-CTR, ID: UMIN000036574, Principal investigator: Taro Fujitani, 04/22/2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000041671).
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