Retrospective Comparison of the Effects of Intrathecal Morphine and Erector Spinae Plane Block on Postoperative Analgesia in Patients Undergoing VATS

VATSObjectives: This study evaluates the analgesic effects of intrathecal morphine (ITM) and ultrasound-guided erector spinae plane block (ESPB) in managing postoperative pain following video-assisted thoracoscopic surgery (VATS).Methods: This retrospective observational study examined hospital records and anesthesia documents of 40 patients who underwent VATS at a university hospital between January 2021 and January 2022.The patients were divided into two groups: ITM and ESPB.The comparative analysis included cumulative morphine consumption within the initial 12/24 h after VATS, Numeric Rating Scale (NRS) resting/activity scores, rescue analgesic requirements, and the side effect profile.Results: During the first 12 h postoperatively, the ITM group exhibited lower median morphine consumption than the ESPB group (ITM: 1.9 mg [0.85-3] vs. ESPB: 3.65 mg [3-4.23],p=0.003).Further, within the initial 24 h postoperatively, the ITM group also exhibited lower median morphine consumption compared to ESPB (ITM: 4 mg [1.54-5.38] vs. ESPB: 10 mg [10-10], p<0.001).The NRS resting/activity scores were consistently lower in the ITM group than in the ESPB group at all measurement times (p<0.001).The number of patients receiving rescue analgesic medication was lower in the ITM group than in the ESPB group (ITM, n=6 [30%] vs. ESPB, n=20 [100%]; p<0.001).The side effect profiles of both groups were comparable.Conclusion: ITM reduced morphine consumption, pain scores, and the requirement for rescue analgesia compared with ESPB, with a comparable side effect profile after VATS.