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Published on: May 26, 2023
Erector spinae plane block improves postoperative analgesia and pulmonary function recovery after thoracoscopic
Lin Xu1, Jiying Ao1, Wanjun Yao1
1Wuhan No.1 Hospital, Wuhan, China.
Background:
Postoperative pain management following thoracoscopic lobectomy remains challenging, potentially impairing pulmonary function and recovery. This study evaluated the effects of ultrasound-guided erector spinae plane block (ESPB) on pain control and pulmonary function in these patients.
Methods:
This retrospective cohort study included 120 patients who underwent thoracoscopic lobectomy between January 2022 and December 2024 at a tertiary care center. Patients received either ultrasound-guided ESPB with 0.375% ropivacaine (n = 60) or conventional analgesia alone (n = 60). All patients received standardized general anesthesia and patient-controlled analgesia with morphine postoperatively. Primary outcomes included 0-10 visual analog scale (VAS) pain scores at 1, 6, 12, and 24 h and pulmonary function parameters (FEV1, FVC) on postoperative days 1 and 3. Secondary outcomes included morphine consumption, time to first analgesic request, complications, hospital stay, and patient satisfaction.
Results:
The ESPB group demonstrated significantly lower VAS scores at all-time points compared to controls (24-h VAS: 3.2 vs. 5.6; p < 0.001; Cohen's d = 1.91). Total 24-h morphine consumption was reduced by 42.6% in the ESPB group (20.5 mg vs. 35.7 mg; p < 0.001). Pulmonary function was significantly better preserved in the ESPB group, with higher FEV1 and FVC values on postoperative days 1 and 3 (all p < 0.01). Pain scores negatively correlated with pulmonary function parameters across the entire cohort, independent of group (r = -0.45 to -0.50; p < 0.001). Hospital stay was shorter (5.2 vs. 6.5 days; p = 0.001) and patient satisfaction higher (4.5 vs. 3.8; p < 0.001) in the ESPB group. Complication rates were comparable between groups.
Conclusion:
Ultrasound-guided ESPB enhances postoperative pain control and pulmonary function recovery without added risks, supporting its integration into multimodal analgesia protocols for thoracoscopic lobectomy.
