Retrolaminar block combined with erector spinae plane block for postthoracotomy pain: a randomized controlled trial

Aim Novel chest wall blocks were developed as the erector spinae plane block (ESPB) and retrolaminar block (RLB) to overcome postthoracotomy pain. The current study aimed to assess the safety and efficacy of combined RLB and ESPB versus ESPB alone for pain management following thoracotomy. Settings and design This randomized, double-blinded, parallel-group clinical trial was conducted at the university hospital. Patients and methods A total of 32 patients were enrolled in this study and were randomly assigned into two groups (16 patients each). The intervention group (ESPB/RLB) received preoperative ESPB using 10 ml of bupivacaine 0.25% plus RLB using 10 ml of bupivacaine 0.25% on the operated side, while the control group received preoperative ESPB only using 20 ml of bupivacaine 0.25% on the same side of the operation. Results The two groups showed no significant difference regarding pain, opioid consumption, hemodynamics, or time to first analgesic request. Conclusions The combination of ESPB and RLB did not demonstrate a superior analgesic effect for postthoracotomy pain compared with ESPB alone. However, it did result in a slightly lower incidence of postoperative nausea and vomiting, and hypotension.