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Analgesia and Pain Management

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...

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Related Experiment Video

Updated: May 14, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

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Pain Management Approaches for Robotic-Assisted Thoracic Surgery: A Retrospective Analysis.

Michael Alexander Semyonov^1,2, Moshe Shmueli^2,3, Alexander Smirnov^1,2

¹Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Beer Sheva, Israel.

Journal of Pain Research

|November 20, 2025

Summary

This summary is machine-generated.

Erector spinae plane (ESP) and serratus anterior plane (SAP) blocks offer superior pain management for robotic-assisted thoracic surgery (RATS). These regional anesthesia techniques reduce postoperative pain and opioid consumption compared to general anesthesia (GA).

Keywords:

erector spinae plane block opioid use paravertebral block postoperative pain regional anesthesia robotic-assisted thoracic surgery thoracic epidural

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Area of Science:

Anesthesiology
Thoracic Surgery
Pain Management

Background:

Robotic-assisted thoracic surgery (RATS) is a growing procedure.
Optimal pain management is crucial for RATS patients.
Regional anesthesia techniques are alternatives to general anesthesia (GA).

Purpose of the Study:

Compare analgesic effectiveness of regional anesthesia techniques versus GA in RATS.
Evaluate perioperative outcomes associated with different pain management strategies.

Main Methods:

Retrospective cohort study of 158 adult patients undergoing elective RATS.
Groups: Thoracic Epidural Analgesia (TEA), Thoracic Paravertebral Block (PVB), Erector Spinae Plane (ESP) block, Serratus Anterior Plane (SAP) block, or GA alone.
Primary outcomes: Postoperative pain (VAS) and opioid consumption. Secondary outcomes: Hemodynamic stability, complications, hospitalization length.

Main Results:

ESP and SAP blocks showed significantly lower Post-Anesthesia Care Unit (PACU) morphine use and VAS scores compared to GA.
PVB also demonstrated reduced pain scores compared to GA.
TEA and PVB were associated with more frequent hypotension and vasopressor use.
ESP and SAP blocks maintained better hemodynamic stability.

Conclusions:

ESP and SAP blocks are effective for pain control in RATS, reducing pain and opioid requirements.
These regional techniques offer improved hemodynamic stability over GA.
Further prospective studies are needed due to small sample sizes in some groups.