Did the new continuous erector spinae plane block anesthetic method combined with venous PCA reduce opioid use and patient pain in the postoperative period of robotic thoracic surgeries?

• Grant number: 24/10367-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2024
• End date: September 30, 2025
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Ricardo Mingarini Terra
• Grantee: Marina Cardoso de Castro José
• Host Institution: Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE). Sociedade Beneficente Israelita Brasileira Albert Einstein (SBIBAE). São Paulo , SP, Brazil

Abstract

Lung resection is the standard treatment for lung cancer, with robotic-assisted thoracic surgery (RATS) gaining prominence in recent years. Few prospective studies address the postoperative (PO) period of RATS, especially regarding pain. The use of opioids in the PO period is common but brings various adverse effects and contributes to an exponential opioid abuse epidemic, especially in countries like the USA. Protocols such as Enhanced Recovery After Surgery (ERAS) aim to reduce perioperative opioid use. This article compares anesthetic techniques in the postoperative period of RATS between public and private hospitals, focusing on a new method that combines continuous erector spinae plane block with venous PCA to reduce opioid use and pain levels. Other postoperative aspects will also be evaluated, such as ambulation, urinary retention, nausea, constipation, drain removal, adverse events, and early hospital discharge. The study is observational, with data collected prospectively from 108 patients, equally divided between public and private hospitals. Morphine dosage will be measured at 24 and 48 hours postoperatively, and pain will be assessed using the Numerical Pain Scale at various postoperative moments. Secondary variables will be based on patient records.