The Use of Erector Spinae Block Compared to Intercostal Nerve Block in Adult Patients (above 18 years) Undergoing Video-Assisted Thoracoscopic Surgery (VATS) to Reduce Opioid Usage and Ensure Effective Pain Control.

Background: Video Assisted Thoracoscopic surgery (VATS) is associated with significant post- operative pain. Studies have shown patient dissatisfaction post-procedure due to increased pain. The erector spinae (ESP) block provides analgesia to the chest wall, resulting in less opioid consumption and improved pain scores. This doctoral project seeks to answer the PICO question “In adult patients undergoing video-assisted thoracoscopic surgery (VATS), does the use of erector spinae block result in less opioid usage and effective pain control compared to intercostal nerve block?” Method: Several databases were utilized to support the study, including Cochrane Library, CINAHL, PubMed, Scopus, and MEDLINE. Inclusion criteria included adults undergoing VATS, ESP block, randomized controlled trials, publications dating 2018-present, English language. The 10 most pertinent publications were reviewed and selected for the study. Results: The literature found that the use of ESPB provides superior analgesia compared to ICNB. Gams et al., reported significantly lower numerical pain score rating in patients with ESP block. Yang et al., also reported lower pain scores after 1-24 hours post procedure in patients with ESPB vs. ICNB. Collectively, the data proves the effectiveness of ESPB in pain management after VATS. Discussion: A key limitation was the sample size; a broader sample size might have provided a more accurate understanding on providers knowledge on the use of ESP blocks. In conclusion, the project demonstrated increased participants knowledge of the effectiveness of ESP block for pain management following VATS. Key Words: video-assisted thoracoscopic surgery (VATS), erector spinae block, intercostal nerve block, postoperative pain.