Effect of thoracic paravertebral block and erector spinae plane block on postoperative gastrointestinal function and quality of recovery in patients undergoing thoracoscopic lobectomy: a randomized controlled trial.

OBJECTIVE

This study aimed to investigate the effects of thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) on postoperative gastrointestinal function and quality of recovery (QoR) in patients undergoing thoracoscopic lobectomy.

METHODS

Ninety-six patients were randomized into three groups: general anesthesia alone (Group G), general anesthesia + TPVB (Group GT), and general anesthesia + ESPB (Group GE). The primary outcome was the incidence of postoperative abdominal distention, while secondary outcomes included time to first exhaust/defecation, bowel sound recovery, postoperative nausea and vomiting (PONV), QoR-15 scores, pain intensity (VAS), perioperative sufentanil consumption, and hospital stay.

RESULTS

Both GT and GE groups demonstrated significantly lower abdominal distention rates (all p < 0.05) and reduced PONV incidence compared to G (all p < 0.05). Time to first exhaust and defecation were shorter in intervention groups(all p < 0.001). Bowel sound recovery rates at 12-48 h postoperatively were higher in GT and GE compared to G (all p ≤ 0.020). QoR-15 scores at 12, 24, and 48 h were elevated in GT and GE versus G (all p < 0.001). VAS pain scores at 1-12 h and sufentanil consumption were lower in GT and GE (p < 0.001). Hospital stay was shorter in intervention groups (all p < 0.001).

CONCLUSIONS

The preoperative ultrasound-guided single TPVB and ESPB could reduce the postoperative abdominal distention rates, shorten the time to first exhaust and defecation, decrease the sufentanil consumption and postoperative VAS pain score, elevate the postoperative QoR-15 score in patients undergoing thoracoscopic lobectomy.