TY - JOUR T1 - Comparison of ultrasound-guided erector spinae plane block and thoracic paravertebral block for postoperative analgesia after video-assisted thoracic surgery: a randomized controlled non-inferiority clinical trial JF - Regional Anesthesia & Pain Medicine JO - Reg Anesth Pain Med DO - 10.1136/rapm-2019-100827 SP - rapm-2019-100827 AU - Yasuko Taketa AU - Yumi Irisawa AU - Taro Fujitani Y1 - 2019/11/08 UR - http://rapm.bmj.com/content/early/2019/11/08/rapm-2019-100827.abstract N2 - Background and objectives The anesthetic characteristics of ultrasound-guided erector spinae plane block (ESPB) remain unclear. We compared the analgesic efficacies of ESPB and thoracic paravertebral block (TPVB) for analgesia after video-assisted thoracic surgery (VATS).Method In this prospective randomized non-inferiority trial, 88 patients undergoing VATS randomly received ESPB or TPVB. All patients received continuous infusion of 0.2% levobupivacaine (8 mL/hour) after injection of a 20 mL 0.2% levobupivacaine bolus. The primary outcome was median differences between the groups in postoperative numerical rating scale (NRS) scores at rest, 24 hours postoperatively.Results Eighty-one patients completed the study. The median difference in NRS scores at rest 24 hours postoperatively was 1 (range 0–1), demonstrating the non-inferiority of ESPB to TPVB. NRS scores at rest were significantly lower in the TPVB group at 1, 2 and 24 hours postoperatively (p=0.02, 0.01 and 0.006, respectively). NRS scores on movement were similar. More dermatomes in parasternal regions were anaesthetized in the TPVB group (p<0.0001). Total plasma levobupivacaine concentrations were significantly lower in the ESPB group within 20 hours postoperatively (p=0.036).Conclusions The analgesic effect of ESPB after VATS was non-inferior to that of TPVB 24 hours postoperatively.Trial registration number UMIN000030658. ER -