Trial reportAnesthesiology2025
Erector Spinae Plane Block versus Intercostal Nerve Blocks in Uniportal Videoscopic-assisted Thoracic Surgery: A Multicenter, Double-blind, Prospective Randomized Placebo-controlled Trial.
Trial report in Anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed.
- Erector spinae plane block.BJA education · 2026Review
- Pain management strategies following thoracic surgery: best practices and innovations.Journal of thoracic disease · 2026Review
- Efficacy of Ultrasound-Guided Intercostal Nerve Block With Liposomal Bupivacaine for Treating Postherpetic Neuralgia in Adult Patients.The Kaohsiung journal of medical sciences · 2026Article
- Intercostal nerve blocks should set the standard for regional analgesia in video-assisted thoracic surgery.Journal of thoracic disease · 2026Article
- Intercostal nerve blockJournal of thoracic disease · 2026Article
- Intercostal nerve blocks take the lead: rethinking regional analgesia for video-assisted thoracic surgery.Journal of thoracic disease · 2026Article
- Effect of Liposomal Bupivacaine for Intercostal Nerve Block on Chronic Postoperative Pain Following Video-Assisted Thoracoscopic Lung Resection: A Retrospective Cohort Study.Drug design, development and therapy · 2026Article
- Efficacy of repetitive transcranial magnetic stimulation on postoperative pain in patients undergoing video-assisted thoracoscopic surgery: study protocol for a prospective, single-center, randomized controlled trial.Frontiers in medicine · 2026Article
- The future of lung cancer surgery lies between innovations: synergy across the perioperative ERATS pathway.Frontiers in oncology · 2026Review
- Application of tubeless anesthesia for enhanced recovery after thoracoscopic wedge resection of the lung: a randomized trial.Journal of thoracic disease · 2025Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough intercostal nerve blocks are sometimes approached with caution due to concerns about potentially high local anesthetic uptake, they remain a valuable tool in specific clinical situations. On the other hand, the erector spinae plane block is currently often favored for its broader coverage and versatility. The hypothesis was that the intercostal nerve block, applied directly by surgeons under direct vision in patients undergoing uniportal video-assisted thoracoscopic surgery, might offer superior analgesia and fewer complications compared to the erector spinae plane block.
methodsIn this multicenter, double-blind, placebo-controlled randomized trial, 100 patients undergoing uniportal thoracoscopic surgery (wedge excision or lobectomy) within an enhanced recovery program received either a surgical intercostal nerve block under thoracoscopic guidance or an ultrasound-guided erector spinae plane block, followed by 30 ml ropivacaine 0.5% (n = 50) or saline (n = 50). The primary outcome measured was 12-h morphine consumption postextubation. Secondary outcomes included 24-h morphine use, pain severity, rescue analgesia need, postoperative complications, and length of stay. Plasma levels of local anesthetics were also assessed.
resultsThe intercostal nerve block group had significantly lower mean 12-h morphine consumption compared to the erector spinae plane block group (10.9 mg vs . 17.6 mg; P = 0.0015), as well as lower mean 24-h consumption (18.7 mg vs . 26.7 mg; P = 0.018). Intercostal blocks also led to lower pain scores in the first 2 h postoperatively and a reduced need for rescue analgesia (16% vs . 40%; P = 0.0033). No differences were found in patient satisfaction, complications, or length of stay. Notably, the erector spinae plane block group showed higher systemic absorption of local anesthetics.
conclusionsFor uniportal thoracoscopic surgery, intercostal nerve block significantly reduces morphine consumption and systemic anesthetic absorption compared to erector spinae plane block.
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