Background and Aims Perioperative thoracotomy pain management with reduced opioid consumption is beneficial for early recovery. Both erector spinae and serratus anterior plane block have been used in thoracic surgeries. We aimed to compare the USG erector spinae and serratus anterior plane blocks on cumulative opioid consumption and recovery.
Methods After ethical committee clearance, a prospective, randomised study was conducted in patients aged 5 to 14 years undergoing open thoracotomy under general anaesthesia. Seventy patients were allocated randomly into two equal groups of 35 each: Group 1 received Serratus anterior plane block while Group 2 received Erector spinae block respectively. Each group received 0.5 ml/kg of 0.25% bupivacaine with 2 micrograms/ml of fentanyl. The primary outcome of our study was to compare the cumulative opioid consumption between the two groups. The study’s secondary outcome was to determine the time of chest physiotherapy initiation, postoperative hospital stay, postoperative pain scores and complications between the two groups.
Results Mean opioid requirement during intraoperative, postoperative period and cumulative was more in Group 1 than in Group 2 with p values of 0.0002, 0.0032 and 0.0024 respectively. The mean time to start chest physiotherapy & mean postoperative hospital stay were higher in Group1 than in Group2 (p-value 0.002 & 0.046 respectively).
Conclusions Ultrasound-guided Erector Spinae block is superior to Serratus anterior plane block in children undergoing thoracic surgery with decreased perioperative opioid analgesia, early chest physiotherapy initiation, and lesser hospital stay.
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