TY  - JOUR
T1  - Comparison of thoracic epidural and peripheral regional analgesia  techniques for postoperative pain management in video-assisted  thoracoscopic surgery (VATS) procedures: a retrospective study
TT  - Video yardımlı torakoskopik cerrahi (VATS) girişimlerinde postoperatif ağrı yönetimi için torakal epidural ve periferik rejyonel analjezi tekniklerinin karşılaştırılması: tek merkezli retrospektif bir analiz
AU  - Mendes, Ergun
AU  - Yaylak, Doruk
AU  - Sincer, Yasemin
AU  - Manici, Mete
AU  - Gürkan, Yavuz
PY  - 2025
DA  - September
Y2  - 2025
DO  - 10.38053/acmj.1752156
JF  - Anatolian Current Medical Journal
JO  - Anatolian Curr Med J / ACMJ / acmj
PB  - MediHealth Academy Yayıncılık
WT  - DergiPark
SN  - 2718-0115
SP  - 583
EP  - 588
VL  - 7
IS  - 5
LA  - en
AB  - Aims: Effective postoperative analgesia is essential in thoracic surgery to preserve respiratory function, facilitate early mobilization, and reduce pulmonary complications. Thoracic epidural analgesia (TEA) has traditionally been regarded as the gold standard for pain control. However, the increasing use of minimally invasive approaches such as video-assisted thoracoscopic surgery (VATS) has prompted the adoption of ultrasound-guided peripheral regional anesthesia techniques, including the paravertebral block (PVB), erector spinae plane block (ESPB), and serratus anterior plane block (SAPB). This study aimed to compare TEA and peripheral regional blocks in terms of postoperative pain scores, opioid consumption, and recovery parameters in patients undergoing VATS procedures.Methods: This retrospective study included patients who underwent elective VATS between January 2023 and January 2025. Based on the analgesic technique received, patients were divided into two groups: TEA (n=82) and peripheral block group (PER, n=65). Pain was assessed using the Visual Analog Scale (VAS) at the post-anesthesia care unit (PACU) and at 24, 48, and 72 hours postoperatively. Opioid doses were standardized to morphine milligram equivalents (MME). Additional outcomes included intraoperative opioid use, postoperative rescue analgesia, length of hospital stay (LOS), complication rates, and 90-day mortality.  Results: Patients in the TEA group had significantly lower VAS scores at all time points compared to the PER group (p
KW  - Thoracic epidural analgesia
KW  - video-assisted thoracoscopic surgery
KW  - paravertebral block
KW  - erector spinae plane block
KW  - serratus anterior plane block
KW  - postoperative pain
N2  - Giriş/Amaç: Toraks cerrahisinde etkili postoperatif analjezi, solunum fonksiyonlarının korunması, erken mobilizasyonun sağlanması ve pulmoner komplikasyonların azaltılması açısından kritik öneme sahiptir. Torakal epidural analjezi (TEA), geleneksel olarak ağrı kontrolünde “altın standart” olarak kabul edilmiştir. Ancak, video yardımlı torakoskopik cerrahi (VATS) gibi minimal invaziv yaklaşımların giderek daha yaygın hale gelmesi, ultrason eşliğinde uygulanan paravertebral blok (PVB), erector spinae plane blok (ESPB) ve serratus anterior plane blok (SAPB) gibi periferik rejyonel anestezi tekniklerinin kullanımını artırmıştır. Bu çalışma, VATS uygulanan hastalarda TEA ve periferik rejyonel blokların postoperatif ağrı skorları, opioid tüketimi ve iyileşme parametreleri açısından karşılaştırılmasını amaçlamaktadır.Gereç ve Yöntem: Bu retrospektif kohort çalışmaya, Ocak 2023 ile Ocak 2025 tarihleri arasında elektif VATS geçiren hastalar dahil edilmiştir. Uygulanan analjezi tekniğine göre hastalar iki gruba ayrılmıştır: TEA (n=82) ve periferik blok (PER, n=65). Ağrı düzeyleri, anestezi sonrası bakım ünitesinde (PACU) ve postoperatif 24, 48 ve 72. saatlerde görsel analog skala (VAS) kullanılarak değerlendirilmiştir. Opioid dozları morfin miligram eşdeğeri (MME) olarak standartlaştırılmıştır. Ek olarak değerlendirilen sonuçlar arasında intraoperatif opioid kullanımı, postoperatif kurtarma analjezisi ihtiyacı, hastanede kalış süresi (LOS), komplikasyon oranları ve 90 günlük mortalite yer almıştır.Bulgular: TEA grubundaki hastalar, tüm zaman noktalarında PER grubuna kıyasla anlamlı olarak daha düşük VAS skorlarına sahipti (p
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UR  - https://doi.org/10.38053/acmj.1752156
L1  - https://dergipark.org.tr/tr/download/article-file/5095986
ER  -