Video-assisted Thoracoscopic surgery (VATS) is a minimally invasive surgical method used
in the diagnosis and treatment of diseases in the chest area. Thoracoscopic surgery has
many advantages, such as being less invasive, less risk of complications, shorter
hospital stay, and better cosmetic results. However, these participants may experience
severe pain in the postoperative period, although not as much as in surgeries performed
with open surgical methods, that is, thoracotomy. This pain, which occurs in the
postoperative period in VATS methods, which is one of the minimally invasive methods, may
prevent the participants from taking deep breaths, as well as cause deterioration of
respiratory functions, serious pulmonary complications such as atelectasis, hypoxia and
infection, and prolonged postoperative patient stay. As the development of morbidity and
mortality. Delay or deterioration in postoperative respiratory functions is one of the
most troublesome complications of thoracic surgery. It was reported that acute pain in
the postoperative period should be effectively controlled with effective analgesia
methods in order to prevent postoperative pulmonary complications and accelerate the
patient's well-being. Controlling pain with postoperative analgesia allows participants
to breathe more deeply, perform breathing exercises more effectively, and therefore
improves and helps preserve respiratory functions. Although thoracic epidural analgesia
is the gold standard method in thoracic surgery, intravenous analgesic techniques and
thoracic trunk nerve blocks are increasingly recommended for postoperative analgesia in
less invasive VATS operations. Thoracic trunk blocks have effects on hemodynamics,
respiratory functions, and consciousness; It has important advantages such as having
fewer side effects than systemic analgesic techniques and being less invasive than
thoracic epidural analgesia. Body blocks are recommended as a first-line analgesia
program, especially in thoracic surgery, as they shorten postoperative recovery time,
reduce the risk of pneumonia and provide early postoperative mobilization. The ease of
application of the erector spinae plane block (ESP), its low risk of complications, and
its ability to provide effective analgesia, especially in minimally invasive surgeries,
have increased its use. Paravertebral block (PVB), one of the other blocks, is frequently
used because it is more reliable and provides effective analgesia compared to thoracic
epidural analgesia and conventional analgesia methods. Thoracic trunk plane blocks can
significantly reduce intravenous opioid use and prevent side effects related to opioid
use with the effective analgesia they provide in the early postoperative period, increase
participants' comfort and painlessness, and accelerate recovery while preventing
deterioration in respiratory function parameters. during rest and mobilization. Because;
It is thought that by applying erector spinae plane block (ESP) or paravertebral block
(PVB), postoperative pain scores and opioid consumption will decrease significantly and
respiratory functions will return earlier. In this study, we aimed to evaluate the
effects of ESP or PVB on respiratory functions in the early postoperative period in
patients undergoing VATS, and in which block there would be less percentage change
between preoperative and postoperative respiratory function test (PFT) parameters.
Pain is a symptom known to be subjective and will be queried with a standardized scale,
the visual pain score scale (VAS), to minimize differences between participants.
Postoperative rest and movement pain scores (VAS; 0, 1, 2, 4, 6, 12, 24 and pre-discharge
scores), postoperative 6th hour, 24th hour and predischarge pulmonary function test (PFT)
parameters, total Analgesic consumption will be recorded at 0, 1, 2, 4, 6, 12, 24 hours
and before discharge.
Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 Second (FEV1), FEV1/FVC, Peak
Expiratory Flow (PEF) values will be recorded as Respiratory Function Test parameters.
The total narcotic analgesic needs of the participants who received the block will be
recorded with the PCA device placed intravenously postoperatively and their total
Morphine consumption will be recorded.
Participants' satisfaction after the procedure will be questioned with a Likert score
before discharge.
Side effects such as nausea and vomiting that may occur in participants will be
questioned with the simplified post-operative nausea and vomiting impact scale.
Participants' demographic characteristics, comorbidities, operation times and
complications will be recorded and statistically analyzed.