Discussion
postoperative pain, ESPB, hyperalgesia, nausea, itching, constipation, pain, chronic pain, nerve block
ADVERSE EFFECTS, RESPIRATORY DEPRESSION, CHRONIC PAIN
Our study represents the first randomized controlled trial comparing the ESPB and SAPB block in uniportal VATS. To enhance the sensitivity of treatment outcome evaluation, we included a blank control group [The primary endpoint measure for our study was the postoperative consumption of opioid analgesics. Intravenous or oral opioids are currently the most commonly used methods for managing moderate to severe pain. However, it is important to acknowledge the diverse adverse effects associated with opioid analgesics. Acute side effects, including nausea, itching, respiratory depression, and constipation, are frequently observed with opioid use. These adverse effects not only result in prolonged hospital stays but also have unforeseen consequences such as hospital readmissions, dependency, addiction, the development of opioid-induced hyperalgesia, and the onset of chronic pain [In our study, we implemented Patient-controlled Analgesia (PCA) for postoperative pain management, which is considered more effective than standard intravenous opioid painkillers in major surgeries [In contrast to previous studies focusing on multi-port thoracoscopic and robotic thoracoscopic surgeries [In our study, we evaluated pain scores and the incidence of moderate to severe pain to increase the sensitivity of the results. The higher usage of opioid analgesics in the control group and the background dose of PCA in all three groups may explain the similar area under the curve (AUC) for pain scores during rest among the three groups. However, consistent with multiple previous studies [Our study revealed a longer time to the initial administration of sufentanil analgesia in the SAPB group compared to the ESPB group. However, it is important to note that the duration of analgesia can vary significantly between SAPB and ESPB in different studies [Consistent with prior researches [Our study has several limitations. One limitation of our study is that we only evaluated the consumption of sufentanil over a 24-h period. This limited timeframe may not provide a comprehensive understanding of the complete analgesic effect postoperatively. Another limitation is the absence of sensory testing following the nerve block in our study. Furthermore, the use of 20 ml of 0.5% ropivacaine as the local anesthetic might require additional research to determine its optimal use. Additionally, our study was conducted at a single center, which poses limitations on the generalizability of the findings. Consequently, the generalizability and applicability of the study results may be limited and further validation through multicenter studies is warranted.