Comparative Analysis of Erector Spinae Plane Block and Paravertebral Block for Postoperative Pain Control Following VATS within a Thoracic ERAS Protocol

Kahya Y., Güneş S. G., Dursun Ş., Aktürk İ., Yılmaz S., Yıldırım Güçlü Ç., ...Daha Fazla

34th Annual Meeting of Asian Society for Cardiovascular and Thoracic Surgery, Antalya, Türkiye, 16 - 19 Nisan 2026, ss.5, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.5
  • Ankara Üniversitesi Adresli: Evet

Özet

Background:

Enhanced Recovery After Surgery (ERAS) protocols are increasingly implemented in thoracic

surgery to accelerate postoperative recovery and reduce complications. Effective pain

management is a cornerstone of ERAS success, particularly after anatomical lung resections

performed via video-assisted thoracoscopic surgery (VATS). This study aimed to compare the

efficacy of erector spinae plane (ESP) block and paravertebral block (PVB) in controlling

postoperative pain in patients managed under a standardized thoracic ERAS protocol.

Methods:

In this retrospective study, data of 111 consecutive patients who underwent VATS anatomical

lung resection (lobectomy or segmentectomy) between January 2024 and January 2026 at a

tertiary care center and were managed under a thoracic ERAS protocol were analyzed. Patients

were grouped based on the type of regional anesthesia received: ESP (n=62) or PVB (n=49).

Postoperative pain was assessed using the visual analogue scale (VAS) at rest and during

movement at the 2nd, 6th, 12th, 24th, 48th hours and at the time of chest tube removal. Median

scores were compared using the Mann–Whitney U test. A p-value < 0.05 was considered

statistically significant.

Results:

The median age was 63 (range: 27–78), with 57 (51.4%) males and 54 (48.6%) females.

Movement-related VAS scores at the 2nd postoperative hour were significantly lower in the ESP

group [3.0 (0–7)] compared to the PVB group [4.0 (2–7), p = 0.04]. Similarly, pain scores during

chest tube removal favored ESP [2.0 (0–5) vs. 3.0 (1–5), p = 0.04]. No significant differences

were observed at other time points (Table 1).

Conclusion:

Within the framework of a standardized thoracic ERAS protocol, the erector spinae plane (ESP)

block demonstrated non-inferiority to the paravertebral block (PVB) in controlling postoperative

pain following VATS anatomical lung resections. Given its safety profile, ease of application,

and comparable efficacy, ESP block may serve as a valuable alternative to PVB, supporting

individualized analgesic strategies for enhanced patient recovery.