ĐÁNH GIÁ HIỆU QUẢ GIẢM ĐAU TRONG VÀ SAU MỔ CỦA PHƯƠNG PHÁP GÂY TÊ MẶT PHẲNG CƠ DỰNG SỐNG ĐOẠN NGỰC DƯỚI HƯỚNG DẪN CỦA SIÊU ÂM TRONG PHẪU THUẬT LỒNG NGỰC

Abstract

Objective: To evaluate the intra- and postoperative analgesic efficacy of ultrasound-guided lower thoracic erector spinae plane (ESP) block in video-assisted thoracic surgery.

Methods: A randomized controlled clinical study was conducted on 114 patients undergoing video-assisted thoracoscopic surgery, equally assigned to the ESP group (n=57) or morphine patient-controlled analgesia (PCA) group (n=57). Pain was assessed using VAS scores, Vester-Andersen analgesia grading, postoperative morphine consumption, and adverse effects.

Results: Baseline characteristics and surgical factors were comparable between groups (p>0.05). The ESP group achieved better analgesia, with most patients reaching Vester-Andersen grade 3. Postoperative morphine consumption was significantly lower in the ESP group (4.54 ± 2.02 mg vs. 35.93 ± 15.28 mg; p<0.01). Resting VAS scores were <3 in both groups; however, from 12 hours onward, the ESP group showed significantly lower pain scores (p<0.05). For movement-evoked pain, significant differences were observed from the 6th postoperative hour (p<0.05). The incidence of nausea, vomiting, and pruritus was significantly lower in the ESP group (p<0.01).

Conclusion: Ultrasound-guided ESP block provides analgesia comparable to morphine PCA during the first 12 postoperative hours and superior pain control thereafter, while significantly reducing opioid consumption and related adverse effects.