The Effectiveness of Regional Analgesia Techniques in Thoracoscopic Surgeries: A Retrospective Single-Center Study

Abstract

Objective: Appropriate pain treatment before, during, and after surgery positively affects the immune system and prevents chron ic pain. Postoperative thoracotomy pain is both severe and diffi cult to manage. In addition to systemic opioid and non-opioid an -algesics, neuraxial analgesic techniques such as thoracic epidural analgesia or thoracic paravertebral block are widely applied for pain control. Various fascial plane blocks are also used in thoracic surgery. The purpose of this study was to investigate the analge sic effectiveness of regional analgesia techniques used in thoracic surgeries in our clinic. Methods: Following receipt of approval from the Koç University Clinical Research Ethics Committee, the records of 372 patients who underwent video-assisted thoracoscopic surgeries at the VKV American Hospital, Turkey, between January 2019 and December 2021 were reviewed retrospectively. Results: Patients who received epidural analgesia exhibited statis tically significantly lower pain scores and postoperative addition al analgesic needs (p<0.001). Rhomboid intercostal subserratus block as the most effective option for postoperative analgesia among alternative regional analgesia methods according to post operative pain scores and postoperative opioid consumption. Conclusion: We still recommend thoracic epidural as the first choice for patient comfort, especially in clinics where thoracic an esthesia experience is high. Moreover, with the increasing preva lence of fascial plane blocks, we think that rhomboid intercostal blocks may be an important alternative in thoracic surgery.