Comparison of the Methods Used for Pain Management After Posterolateral Thoracotomy

Comparison of the Methods Used for Pain Management After Posterolateral Thoracotomy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of the Methods Used for Pain Management After Posterolateral Thoracotomy Ebru KÜÇÜKÇOTUR KOKURCAN, Sehend DEBBAG, Serkan UYSAL, Erkan Dikmen, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7394459/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Acute postoperative pain remains a significant concern in lung surgery, as it may contribute to morbidity through impaired ventilation. Multimodal analgesia is commonly applied in patients undergoing thoracotomy, and regional anesthesia techniques have gained popularity for postoperative pain control in recent years. While the current evidence is still limited, erector spinae plane (ESPB) block and serratus anterior plane block (SAPB) are considered clinically safe options. However, comparative data regarding the effectiveness of ESPB, SAPB, and intercostal nerve block (ICNB) following open thoracotomy are scarce. Methods: This study aimed to compare postoperative pain scores, opioid and additional analgesic consumption, postoperative complications, and hospital stay between ultrasound-guided ESPB, SAPB, and ICNB in patients undergoing posterolateral thoracotomy. Results: Resting and coughing pain scores were lower in the SAPB and ESPB groups compared with the ICNB group at all postoperative time points (p < 0.05). Additional analgesic consumption was higher in the ICNB group (p < 0.05). ESPB was associated with lower pain scores than SAPB at the first postoperative hour (p = 0.014). Furthermore, the proportion of patients requiring additional analgesics was higher in the SAPB group compared with the ESPB group (p = 0.001). Conclusions: Fascial plane blocks (ESPB and SAPB) were associated with more favorable pain outcomes compared with ICNB in the early postoperative period. Within the fascial plane techniques, ESPB demonstrated lower pain scores at the first postoperative hour and reduced need for additional analgesics compared with SAPB. These findings suggest a potential benefit of ESPB, although further studies with larger populations are warranted to confirm these results. Trial registration: Retrospectively registered Keywords: thoracotomy erector spinae plane block serratus anterior plane block intercostal nerve block post-thoracotomy pain Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7394459","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":513661174,"identity":"84372831-3c21-4436-b030-d1c0e89458e1","order_by":0,"name":"Ebru KÜÇÜKÇOTUR KOKURCAN","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1klEQVRIiWNgGAWjYDACCQYGxgYwi/kAiCtDtBYgxZYA4vKQooXHAMQnrIVfuveZ5IwamzqD22c+v7pRY8HDwH746AZ8WiTnHDeT3HAsTcLgXO4265xjQIfxpKXdwKfF4EYam+TDhsMSBmd4txnnsAG1SPCY4dVij9DC88w45x8RWgwkgFo2QrQwP85tI0KLxJ1jzJYzjqVJzjzDZsac2yfBw0bIL/yz2xhv9tTY8POdYX78OedbnRw/++FjeLUgAzYJMEmschBg/kCK6lEwCkbBKBg5AAAZ8kMp/3A11gAAAABJRU5ErkJggg==","orcid":"","institution":"Etlik City Hospital","correspondingAuthor":true,"prefix":"","firstName":"Ebru","middleName":"KÜÇÜKÇOTUR","lastName":"KOKURCAN","suffix":""},{"id":513661175,"identity":"43a0126b-8e5a-422c-b080-2060eb1e3611","order_by":1,"name":"Sehend DEBBAG","email":"","orcid":"","institution":"Hacettepe University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Sehend","middleName":"","lastName":"DEBBAG","suffix":""},{"id":513661176,"identity":"01d5c371-dcfb-4812-8245-259bf4833138","order_by":2,"name":"Serkan UYSAL","email":"","orcid":"","institution":"Hacettepe University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Serkan","middleName":"","lastName":"UYSAL","suffix":""},{"id":513661177,"identity":"f42bbf16-4926-4db0-aec2-22ec8e604ed8","order_by":3,"name":"Erkan Dikmen","email":"","orcid":"","institution":"Hacettepe University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Erkan","middleName":"","lastName":"Dikmen","suffix":""},{"id":513661178,"identity":"cb7b8ed4-b819-428a-adec-efd4eadc0ad6","order_by":4,"name":"Bilge ÇELEBİOĞLU","email":"","orcid":"","institution":"Hacettepe University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Bilge","middleName":"","lastName":"ÇELEBİOĞLU","suffix":""}],"badges":[],"createdAt":"2025-08-17 21:53:07","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7394459/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7394459/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104530887,"identity":"7f39feaf-a6fb-45d9-a751-bad9623222f9","added_by":"auto","created_at":"2026-03-13 01:54:51","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":450465,"visible":true,"origin":"","legend":"","description":"","filename":"manuscriptbmcanaesthesiology.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7394459/v1_covered_a8d8abaf-d4ce-4e70-a01c-6ef33aa1b1c1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparison of the Methods Used for Pain Management After Posterolateral Thoracotomy","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Keywords: thoracotomy, erector spinae plane block, serratus anterior plane block, intercostal nerve block, post-thoracotomy pain","lastPublishedDoi":"10.21203/rs.3.rs-7394459/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7394459/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Background: Acute postoperative pain remains a significant concern in lung surgery, as it may contribute to morbidity through impaired ventilation. Multimodal analgesia is commonly applied in patients undergoing thoracotomy, and regional anesthesia techniques have gained popularity for postoperative pain control in recent years. While the current evidence is still limited, erector spinae plane (ESPB) block and serratus anterior plane block (SAPB) are considered clinically safe options. However, comparative data regarding the effectiveness of ESPB, SAPB, and intercostal nerve block (ICNB) following open thoracotomy are scarce.\nMethods: This study aimed to compare postoperative pain scores, opioid and additional analgesic consumption, postoperative complications, and hospital stay between ultrasound-guided ESPB, SAPB, and ICNB in patients undergoing posterolateral thoracotomy.\nResults: Resting and coughing pain scores were lower in the SAPB and ESPB groups compared with the ICNB group at all postoperative time points (p \u003c 0.05). Additional analgesic consumption was higher in the ICNB group (p \u003c 0.05). ESPB was associated with lower pain scores than SAPB at the first postoperative hour (p = 0.014). Furthermore, the proportion of patients requiring additional analgesics was higher in the SAPB group compared with the ESPB group (p = 0.001).\nConclusions: Fascial plane blocks (ESPB and SAPB) were associated with more favorable pain outcomes compared with ICNB in the early postoperative period. Within the fascial plane techniques, ESPB demonstrated lower pain scores at the first postoperative hour and reduced need for additional analgesics compared with SAPB. These findings suggest a potential benefit of ESPB, although further studies with larger populations are warranted to confirm these results. Trial registration: Retrospectively registered","manuscriptTitle":"Comparison of the Methods Used for Pain Management After Posterolateral Thoracotomy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-16 12:46:19","doi":"10.21203/rs.3.rs-7394459/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2e6c3c74-7e61-4db0-a3e2-b669b830d6ca","owner":[],"postedDate":"September 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-13T01:53:42+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-16 12:46:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7394459","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7394459","identity":"rs-7394459","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}