PT  - JOURNAL ARTICLE
AU  - Yasuko Taketa
AU  - Yumi Irisawa
AU  - Taro Fujitani
TI  - 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
AID  - 10.1136/rapm-2019-100827
DP  - 2020 Jan 01
TA  - Regional Anesthesia & Pain Medicine
PG  - 10--15
VI  - 45
IP  - 1
4099  - http://rapm.bmj.com/content/45/1/10.short
4100  - http://rapm.bmj.com/content/45/1/10.full
SO  - Reg Anesth Pain Med2020 Jan 01; 45
AB  - 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.