Comparison of Ultrasound-Guided Erector Spinae Plane Block, Thoracic Paravertebral Block, and Control for Postoperative Recovery in Video-Assisted Thoracic Surgery Patients: A Randomized Controlled Trial

Background: The objective of this study was to examine the effect of ultrasound-guided Erector Spinae Plane Block (ESPB) and Thoracic Paravertebral Block (TPVB) on the quality of recovery (QoR) in video-assisted thoracic surgery (VATS). Methods: A total of 129 patients were randomly assigned to three groups: ESPB group and TPVB group received ultrasound-guided nerve blocks, and Control group received multimodal analgesia protocol only. The primary outcome measure was QoR-15 scale at 24 hours postoperatively. Secondary outcome measures included visual analog scale (VAS) scores at rest and cough, intraoperative remifentanil dosage, number of postoperative patient-controlled intravenous (PCI) self-controlled compressions, and the incidence of adverse effects. Results: The QoR-15 scores at 24 hours postoperatively were significantly higher in ESPB and TPVB group as compared to Control group. The static (at rest) and dynamic (at cough) VAS scores within 7 h of surgery, intraoperative remifentanil dosage, and number of postoperative PCI self-controlled compressions were significantly lower in ESPB and TPVB groups as compared to Control group (all P < 0.001). The occurrence of nausea, vomiting, and dizziness in ESPB and TPVB group was lower than that in Control group ( P < 0.05), whereas other adverse effects were not statistically different between the three groups. Conclusion: The ultrasound-guided ESPB may be a promising form of regional anesthesia to aid recovery after VATS surgery, which is similar to TPVB. Trial Registration: This study has been registered at the Chinese Clinical Trial Registry (ChiCTR2500105099).