Effect of erector spinae plane block and paravertebral block on postoperative recovery quality in patients undergoing thoracoscopic lung cancer surgery

WU Jian; YANG Yanbing

doi:10.3969/j.issn.1009-0460.2025.09.009

Abstract：Objective To explore the effects of erector spinae plane block(ESPB)and thoracic paravertebral nerve block(TPVB)on the postoperative recovery quality of lung cancer patients undergoing video-assisted thoracoscopic surgery(VATS).Methods A total of 106 lung cancer patients who underwent VATS radical resection of lung cancer in Zibo 148 Hospital from November 2023 to December 2024 were selected and divided into the ESPB group(n=53)and the TPVB group(n=53).The main observation indicators were the Numerical Rating Scale(NRS)at rest and in the cough state 24 hours after surgery(H24),as well as the Quality of Recovery-15(QoR-15)scores 1 day before surgery and 48 hours after surgery(H48).Results The median NRS scores at rest for H24 in the ESPB group and the TPVB group[2.00(1.00,2.00)points vs.1.00(1.00,2.00)points,Z=-1.075,P=0.282]and the median NRS scores for cough[3.00(2.00,4.00)points vs.3.00(2.00,4.00)points,Z=-0.482,P=0.630].There were no statistically significant differences.At H48,the total score of QoR-15 in the ESPB group was higher than that in the TPVB group[(133.51±14.12)pointsvs.(127.60±16.98)points,t=2.005,P=0.048],and the improvement of the total score of △QoR-15 was more significant[15.00(3.00,32.00)points vs.12.00(0,25.00)points,Z=-2.158,P=0.027].There was no statistically significant difference in the NRS scores at rest and cough at 6 hours(H6)after surgery and the rate of remedial analgesia between the two groups(P>0.05).The dosage of sufentanil for H24 in the ESPB group was higher than that in the TPVB group(56.05±4.39 μg vs.53.86±5.01 μg,t=2.393,P=0.019).There was no statistically significant difference in postoperative complications between the two groups(P>0.05).The incidence of chronic postoperative pain(CPSP)at 3 months after the operation was 35.0%(35/100).Univariate and multivariate Logistics regression analyses showed that high H24 resting NRS score,high H24 cough NRS score,and low H48 QoR-15 total score were risk factors for CPSP 3 months after surgery(P<0.05),while the anesthesia method had no significant correlation with the occurrence of CPSP.Conclusion Compared with TPVB,ultrasound-guided ESPB can provide comparable analgesic effects for VATS lung cancer patients and achieve better overall postoperative recovery quality.However,the perioperative opioid consumption in the TPVB group is lower.