Comparison of the Effectiveness of Ultrasound-Guided Bilateral Erector Spinae Plane Block and Thoracic Epidural Analgesia Methods in Patients Undergoing Thoracotomy

Effective control of severe post-thoracotomy pain is pivotal for minimizing pulmonary complications and enhancing patient comfort. This prospective, randomized, three-arm study compared the analgesic efficacy of ultrasound-guided bilateral erector spinae plane block (ESPB) and thoracic epidural analgesia (TEA) with conventional intravenous opioid-based care. Seventy-two ASA I-II patients aged 18-80 years undergoing elective thoracotomy were block-randomized to receive TEA, ESPB, or no regional intervention (control). All procedures were performed at the end of surgery before emergence from anesthesia. Pain intensity was assessed at 1, 2, 4, 6, 12, and 24 h postoperatively using the Visual Analog Scale (VAS). Additional outcomes included time to first rescue opioid, total tramadol consumption, time to modified Aldrete score (MAS) ≥ 9, patient satisfaction, and length of hospital stay.