Effect of ESP (Erector Spinae Plane) block for thoracic surgeries - A randomized trial

Post-thoracic surgery pain impairs recovery, prompting evaluation of ultrasound-guided erector spinae plane (ESP) block versus standard multimodal analgesia. This RCT randomized 120 elective thoracic surgery patients to ESP (20 mL of 0.375% ropivacaine, n=60) or control (n=60), assessing NRS pain at 6/12/24 h, opioid use, first analgesic time, satisfaction and complications. ESP reduced NRS scores (6h: 3.2±1.4 vs 5.8±1.9; 12h: 2.9±1.3 vs 5.1±1.7; 24h: 2.1±1.1 vs 4.2±1.6, all p<0.001), 24h morphine (12.4±6.8 vs 28.7±9.2 mg, p<0.001) and extended first analgesia (8.7±3.2 vs 2.1±1.4h, p<0.001), boosting satisfaction (8.6±1.2 vs 6.4±1.8, p<0.001) without complications. ESP block markedly outperforms standard care for thoracic analgesia, minimizing opioids and enhancing recovery metrics. Thus, we document ESP's safety/efficacy in thoracic surgery, suggesting its routine integration into multimodal protocols.