Ultrasound-guided erector spinae plane block versus rhomboid intercostal block for postoperative analgesia following thoracotomy: a prospective, randomized, controlled study
Introduction For pain relief after thoracotomy, opioids and thoracic paravertebral and epidural interventions are frequently used. In recent years, interfascial blocks such as the erector spinae plane block (ESPB) and rhomboid intercostal block (RIB) have started to be used for analgesia. We aimed to compare the postoperative analgesic effect of ESPB, RIB, and a control group in pain management after open thoracotomy. Material and methods This is a randomized controlled trial. A total of 75 patients were included in three groups as the ESPB, RIB, and control (C) groups. In block groups, the blockage was performed with 20 ml 0.25% bupivacaine. In Group C, no procedures other than the standard postoperative analgesia protocol were performed. The postoperative analgesic consumptions of the patients, time of first analgesic need, and visual analog scale (VAS) values were recorded. Results The mean 24-hour tramadol consumption was 124±29.08 mg in group ESPB and 116±28.65 mg in group RIB, and the results were statistically similar (p>0.05). In Group C, the consumption is 204±44.06 mg; significantly higher than group ESPB and group RIB (p=0.004). Time to the first analgesic requirement was 355±55.69 min in group ESPB and 339.12±54.39 min in group RIB. There was no difference between groups (p>0.05). In Group C, this time was 218.91±56.73 minutes. We observed that group ESPB and group RIB needed analgesics later (p=0.006). VAS scores and the number of patients requiring analgesics were similar in group ESPB and group RIB (p>0.05). In Group C, on the other hand, VAS scores and the number of patients requiring analgesics were higher than both groups in which block was applied (p<0.05). Conclusion ESPB and RIB were similar and they are more effective in comparison to the standard protocol in the control group, whereas the former did not have superiority over each other.