Analgesia related to the administration of local anesthetic solution into the fascia of erector spinae muscle is mediated by the effect of local anesthetic on the posterior and lateral branches of the anterior part of the spinal nerve. Comparable analgesic efficiency after the administration of both nerve blocks would reject the widespread theory of the paravertebral site of effect of the local anesthetic in ESPB.
Patiens undergoing VATS-surgery
Age < 20 years
Body Mass Index >35 kg/m2
Technical difficulties with the nerve block administration and/or subsequent bolus application
Abnormal course of the surgery (e.g. conversion to thoracotomy) or the postoperative phase (e.g. surgical revision of the chest)
Parallel
new type of peripheral block Serratus Posterior Plane Block
Procedure/SurgeryIntervention will be Serratus Posterior Plane Block.
Cumulative opioid dose in 72 hours
Irrespective of the type of the block, 20 mls of 0.25 % bupivacaine will be administered to the block catether every 8 hours. Every patients will receive non-opioid analgesics according to standardized ward guideline. VAS score is recorded at least every 3 hours (except for time patient is asleep). Any time patient reports VAS score \>=5, he/she will receive 5 mg of morphine intravenously (or equivalent dose of Oxycodone per os). Cumulative dose of opioids will be recorded.
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