Analgesic Efficacy of Single-Shot Erector Spinae Block in Video-Assisted Thoracoscopic Surgery: A Propensity Score-Matched Retrospective Cohort Study

Introduction Video-assisted thoracic surgery (VATS) is a minimally invasive surgical technique though effective analgesia remains a challenge. Erector spinae plane block (ESPB) has gained popularity due to its ease and safety of placement. In this study, we evaluated the analgesic efficacy of ESPB in patients undergoing VATS through a propensity score-matched retrospective cohort study. The primary outcome is the total opioid use in the first 12 postoperative hours. Methods We used binomial logistic regression to model whether patients received ESPB as a function of age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) physical status, and surgery type to generate a propensity score for each patient for matching. Results After screening 286 patients, 55 patients each in the ESPB and no-block groups were matched. ESPB was associated with a 1.2 mg (95% CI: -2.2 to -0.2) reduction in opioid use in IV hydromorphone equivalents when compared to no block. However, there was no reduction in the 12-hour pain score area under the curve or incidence of complications between the two groups. Conclusions ESPB was associated with a modest reduction in total opioid consumption although not a difference in pain score. While its analgesic efficacy may be limited, ESPB could be considered a component of multi-modal analgesia in VATS.