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PubMed · 42145113

Continuous Ultrasound-guided Erector Spinae Plane Block Versus Thoracic Paravertebral Block for Postoperative Analgesia in Patients Undergoing Thoracotomy.

Rabab M Habeeb·WesamEldin A Sultan·Mohamed E Basune·Amal G Safan
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Abstract

OBJECTIVES: To compare postoperative analgesia using continuous ultrasound-guided erector spinae plane block (ESPB) versus thoracic paravertebral block (TPVB), with dynamic visual analog scale (VAS) during coughing as the primary outcome. Secondary outcomes included static VAS (at rest), hemodynamic changes, side effects, total opioid consumption, time of first rescue analgesia, length of hospitalization, anesthesia recovery time, postanesthesia care unit stay, time to first ambulation, and patient satisfaction. METHODS: The study included 40 cases scheduled for elective thoracotomy admitted to the cardiothoracic surgery unit of Menoufia University Hospital. Patients were equally randomized into 2 groups, 20 patients each receiving either ultrasound-guided ESPB or TPVB (control group). Both groups received 20&#xa0;mL of 0.25% bupivacaine as a loading dose followed by continuous infusion of 0.125% bupivacaine at 5&#xa0;mL/h, with patient-controlled boluses of 20&#xa0;mL on demand. RESULTS: Dynamic visual analogue pain scale scores were significantly lower in the ESPB group at 6, 9, 12, and 24 hours ( P =0.008, 0.035, 0.001, 0.006). Morphine consumption was significantly reduced in the ESPB group ( P < 0.001). Hypotension was more frequent in TPVB (40% vs. 10%, P =0.028). No significant differences were observed in hospital stay or patient satisfaction. DISCUSSION: The utilization of continuous ultrasound-guided ESPB demonstrated better postoperative visual analogue pain scale scores and a significant decrease in opioid consumption, with fewer side effects than TPVB.

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HumansPostoperative PainFemaleNerve BlockMaleThoracotomyMiddle AgedPain MeasurementUltrasonography, InterventionalBupivacaineAnesthetics, LocalAdultTreatment OutcomeAnalgesics, OpioidAgedPatient SatisfactionThoracic VertebraeMorphinethoracic paravertebral blockthoracotomyultrasound-guidedJournal ArticleRandomized Controlled TrialComparative Study

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Rabab M Habeeb, WesamEldin A Sultan, Mohamed E Basune, Amal G Safan. 2026-10-01. Continuous Ultrasound-guided Erector Spinae Plane Block Versus Thoracic Paravertebral Block for Postoperative Analgesia in Patients Undergoing Thoracotomy.. https://doi.org/10.1097/ajp.0000000000001399

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Journal Article; Randomized Controlled Trial; Comparative Study resourceAdult subjectAged subjectAnalgesics, Opioid subjectAnesthetics, Local subjectBupivacaine subjectComparative Study subjectFemale subjectHumans subjectJournal Article subjectMale subjectMiddle Aged subjectMorphine subjectNerve Block subjectPain Measurement subjectPatient Satisfaction subject

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