Comparison of erector spinae plane block and thoracic paravertebral block for analgesia after thoracotomy: ESPB vs TPVB for post-thoracotomy analgesia

Faik Celik; Ayse Mizrak; Elzem Sen; Lutfiye Pirbudak; Ayse Nur Eser

doi:10.28982/josam.8349

Authors

Faik Celik Department of Anesthesiology and Reanimation, University of Gaziantep, Gaziantep, Turkey https://orcid.org/0000-0003-1294-6779
Ayse Mizrak Department of Anesthesiology and Reanimation, University of Gaziantep, Gaziantep, Turkey https://orcid.org/0000-0001-5999-4810
Elzem Sen Department of Anesthesiology and Reanimation, University of Gaziantep, Gaziantep, Turkey https://orcid.org/0000-0003-3001-7324
Lutfiye Pirbudak Department of Anesthesiology and Reanimation, University of Gaziantep, Gaziantep, Turkey https://orcid.org/0000-0002-3474-1056
Ayse Nur Eser Department of Anesthesiology and Reanimation, University of Gaziantep, Gaziantep, Turkey https://orcid.org/0009-0005-5088-7273

DOI:

https://doi.org/10.28982/josam.8349

Keywords:

thoracotomy, erector spinae plane block, postoperative analgesia, paravertebral block, visual analog scale, opioid consumption

Abstract

Background/Aim: Post-thoracotomy pain is severe and often necessitates effective regional analgesia. We aimed to compare the postoperative analgesic efficacy of ultrasound-guided erector spinae plane block (ESPB) versus thoracic paravertebral block (TPVB).

Methods: We retrospectively evaluated 130 adults (ESPB, n=65; TPVB, n=65) undergoing thoracotomy. The primary outcome was pain at rest, assessed using the visual analogue scale (VAS) at 0, 3, 6, 12, and 24 hours postoperatively. Secondary outcomes included postoperative opioid consumption (tramadol, morphine) and adverse events. A prespecified sensitivity analysis adjusted comparisons for sex.

Results: Resting VAS scores did not differ significantly between the ESPB and TPVB groups at any time point (all P>0.05). Postoperative tramadol and morphine consumption were comparable (P=0.093 and P=0.560, respectively). The incidence of adverse events (postoperative nausea/vomiting, shoulder pain, pruritus) was also similar between groups. In sex-adjusted analyses, all group differences remained non-significant.

Conclusion: ESPB and TPVB provide comparable postoperative analgesia and opioid-sparing effects after thoracotomy. Given its potential for greater technical ease and similar efficacy, ESPB represents a reasonable alternative to TPVB. Further prospective research is required to validate these results and assess long-term outcomes.

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