| Summary: | Objective To investigate the effect of ultrasound-guided serratus anterior plane block (SAPB) combined with erector spinae plane block (ESPB) on intraoperative opioid consumption and postoperative analgesia in patients undergoing video-assisted thoracoscopic (VAST) lobectomy. Methods A total of 120 patients undergoing elective VAST lobectomy were randomized into 4 groups before the operation. After general anesthesia, the patients were given ESPB (E group), SAPB (S group), SAPB+ESPB (SE group) and general anesthesia only (G group). All the patients received patient-controlled intravenous analgesia (PCIA) after the operation. The amount of intraoperative opioid consumption, postoperative Visual Analogue Scale (VAS) scores at rest and when coughing, and adverse events and complications associated with analgesia were recorded in all the cases. Results Compared with those in G group, the postoperative VAS scores were significantly lower in the other 3 groups (P < 0.05); the scores were significantly lower in S and SE groups than in E group (P < 0.05), but showed no significant difference between SE and S groups (P>0.05). The intraoperative consumption of opioids, duration of PACU stay and sedation irritability score were all significantly lower or shorter in E, S and SE groups than in G group (P < 0.01). The incidence of postoperative nausea, vomiting and pulmonary complications did not differ significantly among the 4 groups (P>0.05). The mean length of hospital stay was significantly shorter in E, S and SE groups than in G group, and was significantly shorter in SE group than in E group (P < 0.05), but showed no significant difference between S and SE groups or between E and S groups (P>0.05), although SE group had a shorter hospital stay than S group by 0.76 d. Conclusion Ultrasound-guided SAPB, ESPB, and particularly their combination can reduce the intraoperative dose of opioids during VAST lobectomy, lower the incidence of delirium in PACU and shorten the duration of PACU stay without increasing adverse reactions to promote the patients' early recovery and discharge.
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