The erector spinae plane (ESP) block is a widely used regional anesthesia technique for postoperative analgesia in thoracic surgery. The block can be performed in different patient positions, most commonly sitting or lateral decubitus, but the effect of patient position on dermatomal sensory spread and analgesic efficacy has not been clearly established.
This prospective, randomized, single-blind clinical trial aims to compare the effects of ESP block performed in sitting versus lateral decubitus position on dermatomal sensory distribution and postoperative analgesic outcomes in patients undergoing video-assisted thoracic surgery.
Age 18 to 75 years
ASA physical status II-IV
Scheduled for elective video-assisted thoracic surgery
Ability to provide written informed consent
Known allergy to local anesthetics
Chronic opioid use
Preexisting chronic pain
Severe cognitive impairment
Parallel
Erector Spinae (ESP) Block with Bupivacaine (Marcaine®) sitting position
DrugErector spinae plane block-sitting position
Erector Spinae (ESP) Block with Bupivacaine (Marcaine®) lateral position
DrugErector Spinae Plane Block-Lateral position
Dermatomal sensory spread
Cranial and caudal sensory limits and total number of dermatomes affected, assessed by cold sensation and pin-prick testing.
Postoperative pain scores (Numeric Rating Scale)
Numeric Rating Scale, 0-10 points, 0=no pain, 10= worst pain imaginable
Total opioid consumption
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