Analgesia protocol
ESPB, pain
DECUBITUS
When the patients in the lateral decubitus position, ESPB was performed at the level of the thoracal(T)5 vertebrae. The probe was placed longitudinally, 2–3 cm lateral from the midline. Anatomical structures were seen. The needle was advanced in the caudo-cranial direction under the erector spinae muscle over the T5 transverse process with the in-plane technique. As a control, hydro-dissection was performed with 2 mL of saline. Then, 30 mL of 0.25% bupivacaine was injected into this area.In this group, the US probe was first placed over the T4 transverse process and then over the T6 transverse process, respectively. For both levels, the needle was advanced as in the One-level group. 15 mL of 0.25% bupivacaine was injected into both injection sites, respectively.Multimodal analgesia was provided by administering 100 mg tramadol and 50 mg dexketoprofen intravenously (IV) at the end of the surgery. 10 mg metoclopramide was given to prevent nausea/vomiting. In the postoperative period, 50 mg dexketoprofen every 12 h and 1 g paracetamol every 8 h were given. In addition, IV PCA prepared with morphine was administered to the patients. The PCA pump’s dose delivery was limited to administering a bolus dose of 1 mg of morphine and delivering a maximum dose of 12 mg of morphine in total within 4 h with lockout intervals of 15 min. The pain was defined with a 0–10 point (0: No pain and 10: Unbearable pain) VAS. When the VASr score was ≥ 4, 0.5 mg/kg of tramadol was administered via IV for rescue analgesia. The patients, who were followed up in the surgical intensive care unit for 24 h, were then transferred to the ward.Block applications were performed by two anesthetists who are experienced in the use of the US in both centers. VAS follow-ups of the patients were performed by pain management nurses who did not know (blinded) the type of block applied to the patient and were not included in the study.VASr and VASc scores were recorded in the postoperative 1