Abstract No. : ABS3342: Comparison of erector spinae block versus epidural catheter infusion for analgesia in thoracic surgery

BACKGROUND & AIMS: Theprimary objective was to compare the efficacy of analgesia provided by epidural catheter and erector spinae blockin the postoperative period based onnumerical rating scale. Rescue analgesia, time of mobilisation, any complications associated were assessed as secondary objectives. METHODS: This Prospective randomised single-blinded comparative study included 76 patients of American Society of Anesthesiologists grade I, II and III. Haemodynamicdata including heart rate, blood pressre and oxygen saturation were recorded preoperatively, 5 minutes after induction, 5 minutes after nerveblock/epidural, at skin incision, 20 minutes after incision. Local anaesthetic infusion of 0.125% bupivacaine + 2 µg/mlfentanyl was given @ 6-8 ml/h at 1 h after block/epidural.Postoperative pain assessment was done for pain at rest anddynamic pain with Numerical rating scale (NRS) and sedation level based on the Ramsay sedation scale was noted. The need for rescueanalgesia and complications was documented. RESULTS: NRS score at rest was statistically significant in the period between 12 to 24 h, while thedynamic score was found to be statistically significant from 4 to 24 h. The epidural group required more rescue analgesic and total amount of intraoperative fentanyl doses compared to the erector spinaegroup with a P-value of 0.02. CONCLUSION: Ultrasound-guided ESP block is comparable with thoracic epidural technique in patientsundergoing elective thoracotomy with regards to post operative analgesia, less opioid requirement, patient satisfaction, and fewer complications.