Intercostal nerve block is superior than erector spinae plane block after uniportal video-assisted thoracoscopic surgery: randomized controlled trial.

In this double-blinded, randomized controlled trial, sixty patients undergoing elective uniportal video-assisted thoracoscopic surgery (VATS) lobectomy were randomly assigned to receive thoracoscopic intercostal nerve block (ICNB, n ​= ​30) or ultrasound-guided erector spinae plane block (ESPB, n ​= ​30). No block-related adverse events occurred. The ICNB group showed significantly lower resting and coughing visual analog scale scores, than the ESPB group, 4 (4.0 and 5.0 versus 5.0 and 6.0, p ​= ​0.006 and 0.012) and 8 (3.0 and 4.0 versus 5.0 and 6.0, p ​= ​0.003 and 0.017) hours postoperatively. The ESPB group consumed morphine significantly earlier (1.5 versus 10 ​h, p ​= ​0.002), and had a higher 24-h cumulative consumption (11 versus 7 ​mg, p ​= ​0.103). No differences were observed in postoperative nausea, vomiting, complications, drainage duration, or hospital stay. ICNB demonstrated superior early analgesic efficacy, whereas ICNB and ESPB depicted safety and facilitated rapid recovery following uniportal VATS lobectomy.