Prolonged Effect of Repetitive Erector Spinae Plane Block in Reducing Thoracic Pain Caused by Lung Cancer

TL;DR

This study shows that repeated erector spinae plane blocks can significantly and long-lasting reduce thoracic pain in lung cancer patients.

Contribution

The study demonstrates the prolonged analgesic effect of repetitive erector spinae plane blocks in lung cancer-related thoracic pain management.

Findings

Repeated ESPBs significantly reduced thoracic pain for up to three months in lung cancer patients.

A 50% reduction in VAS scores was maintained even at the third month of follow-up.

The intervention was found to be safe with only minor complications observed.

Abstract

Introduction: Pain significantly affects the quality of life of lung cancer patients. We aimed to evaluate the effect of the erector spinae plane block (ESPB) on pain in these patients.

Methods: We reviewed the medical records of patients with primary lung and bronchial cancer who experienced refractory pain in the thoracic region and underwent repeated ESPBs (three blocks at 24-hour intervals) between 2019 and 2020 in this single-center retrospective study. Visual analog scale (VAS) scores recorded before the procedure and on the first day (first day after the third block) and the first and third months of follow-up in 43 patients were analyzed.

Results: The study population consisted of 31 male and 12 female patients, with a mean age of 56.7 years. The mean pre-procedure VAS score was 8.9±0.8, which showed a significant decrease on the first day (2.9), first month (3.6), and third month (4.6) of the follow-up. Four patients experienced minor complications (pain at the procedure site and hypotension); however, no major complications were observed.

Conclusion: We observed a prolonged effect of repeated ESPBs for ≥3 months. The block efficacy decreased with time; however, an approximately 50% reduction in the VAS score persisted even in the third month. Repetitive ESPBs may be regarded as a straightforward, safe, and replicable intervention to complement medical treatment and diminish the need for opioids in managing lung cancer-related pain.

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