Erector Spinae Plane Block versus Intercostal Nerve Blocks in Uniportal Videoscopic-assisted Thoracic Surgery: A Multicenter, Double-blind, Prospective Randomized Placebo-controlled Trial
Authors' conclusion
For uniportal thoracoscopic surgery, intercostal nerve block significantly reduces morphine consumption and systemic anesthetic absorption compared to erector spinae plane block.
Study context
- Population
- Patients undergoing uniportal thoracoscopic surgery (wedge excision or lobectomy) within an enhanced recovery programropivacaine n = 50, saline n = 50
- Participants
- 100 patients
- Comparison
- Surgical intercostal nerve block vs ultrasound-guided ESP block
- Primary endpoint
- Morphine consumption postextubation
- Follow-up
- 12 h
Methodological detailsmulticentre, double-blind, placebo-controlled
- Multicentre
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
Mean morphine consumption
P = 0.0015
Secondary outcomes
Morphine consumption · 24 h
P = 0.018
Pain scores · first 2 h postoperatively
- Lower pain scores with intercostal blocks
Need for rescue analgesia
- Reduced need for rescue analgesia with intercostal blocks vs ESP block
- 16% vs . 40%
- P = 0.0033
Patient satisfaction, complications, LOS
- No differences
Safety
Postoperative complications
- No differences
Systemic absorption of local anesthetics (plasma levels)
- Higher systemic absorption in the ESP block group
Original publication
Erector Spinae Plane Block versus Intercostal Nerve Blocks in Uniportal Videoscopic-assisted Thoracic Surgery: A Multicenter, Double-blind, Prospective Randomized Placebo-controlled Trial. Anesthesiology. Published 19 June 2025. doi:10.
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