Abstract：
OBJECTIVE: To compare the analgesic efficacies of erector spinae plane (ESP) block and thoracic epidural analgesia (TEA) in video-assisted thoracic surgery (VATS).
METHODS: Sixty patients undergoing VATS received patient-controlled TEA with a basal rate of 3 ml/hour (h), a bolus of 3 ml (Group E), or ESP block with programmed intermittent bolus infusions of 15 mL/3 h and a bolus of 5 ml (Group ES) for 2 postoperative days. The primary outcome was to compare pain scores at rest 24 h postoperatively between the 2 groups. Secondary outcomes included NRS score for 48 h, procedural time, dermatomal spread, use of rescue medication, adverse events, and patient satisfaction.
RESULTS: Patients with continuous ESP block had a higher NRS score than those with TEA but no statistical difference at a specific time. The dermatomal spread was more extensive in the TEA group than in the ESP block group (p=0.016); cumulative morphine consumption was higher in the ESP block group (p=0.047). The incidence of overall adverse events in the TEA group was higher than in the ESP block group (p=0.045).
CONCLUSIONS: Erector spinae plane block may be inferior to TEA for analgesia following VATS, but it could have tolerable analgesia and a better side effect profile than TEA. Therefore, it could be an alternative to TEA as a component of multimodal analgesia.
METHODS: Sixty patients undergoing VATS received patient-controlled TEA with a basal rate of 3 ml/hour (h), a bolus of 3 ml (Group E), or ESP block with programmed intermittent bolus infusions of 15 mL/3 h and a bolus of 5 ml (Group ES) for 2 postoperative days. The primary outcome was to compare pain scores at rest 24 h postoperatively between the 2 groups. Secondary outcomes included NRS score for 48 h, procedural time, dermatomal spread, use of rescue medication, adverse events, and patient satisfaction.
RESULTS: Patients with continuous ESP block had a higher NRS score than those with TEA but no statistical difference at a specific time. The dermatomal spread was more extensive in the TEA group than in the ESP block group (p=0.016); cumulative morphine consumption was higher in the ESP block group (p=0.047). The incidence of overall adverse events in the TEA group was higher than in the ESP block group (p=0.045).
CONCLUSIONS: Erector spinae plane block may be inferior to TEA for analgesia following VATS, but it could have tolerable analgesia and a better side effect profile than TEA. Therefore, it could be an alternative to TEA as a component of multimodal analgesia.
摘要：
目的：比较竖脊肌平面阻滞（ESP）和胸段硬膜外镇痛（TEA）在电视胸腔镜手术（VATS）中的镇痛效果。
方法：60例接受VATS的患者接受患者控制的TEA，基础速率为3ml/h（h），推注3ml（E组），或ESP阻滞，程序间歇推注15mL/3h和推注5ml（ES组），持续2天。主要结果是比较两组患者术后24h休息时的疼痛评分。次要结局包括48h的NRS评分，程序时间,皮瘤扩散，使用救援药物，不良事件,患者满意度。
结果：连续ESP阻滞患者的NRS评分高于TEA患者，但在特定时间无统计学差异。TEA组比ESP阻滞组更广泛（p=0.016）；ESP阻滞组的累积吗啡消耗量更高（p=0.047）。TEA组的总不良事件发生率高于ESP阻滞组(p=0.045)。
结论：对于VATS后的镇痛，Erectorspinae平面阻滞可能不如TEA，但它可能具有耐受的镇痛作用和比TEA更好的副作用。因此,它可以替代TEA作为多模式镇痛的组成部分。
方法：60例接受VATS的患者接受患者控制的TEA，基础速率为3ml/h（h），
结果：连续ESP阻滞患者的NRS评分高于TEA患者，但在特定时间无统计学差异。
结论：对于VATS后的镇痛，Erectorspinae平面阻滞可能不如TEA，
