الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Thoracotomy is considered the most painful of surgical procedures and providing effective analgesia is the onus for all anesthetists. Ineffective pain relief impedes deep breathing, coughing, and remobilization culminating in atelectasis and pneumonia.
Paravertebral block, especially thoracic paravertebral block, is an effective regional anesthetic technique that can provide significant analgesia for numerous surgical procedures, including breast surgery, pulmonary surgery, and herniorrhaphy. The technique, although straightforward, is not devoid of potential adverse effects.
The erector spinae plane (ESP) block is a novel ultrasound guided regional anesthetic technique belongs to the family of fascial plane blocks in which local anesthetic is injected into a plane between two layers of fascia and subsequently spreads to nerves located within that plane or within adjacent tissue compartments..
Aim of work:
The aim of work of the current study was to compare the efficacy of (U/S)-guided continuous (ESPB) to continuous (TPVB) as a method of pain relief following thoracotomy.
To elucidate this aim, 40 patients randomly divided into two equal groups each group 20 patients:
group A:
Patients will receive Loading dose of 20 ml 0.25% bupivacaine then continuous infusion U/S-Guided TPVB of 5 ml/hr of 0.125% bupivacaine started through the catheter before the surgical procedure intraoperative then boluses on patient demand postoperative.
SUMMARY
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group B:
Patients will receive Loading dose of 20 ml 0.25% bupivacaine then continuous U/S-Guided ESPB of 5 ml/hr of 0.125% bupivacaine started through the catheter before the surgical procedure intraoperative then boluses on patient demand postoperative.
The main results:
In the current study, there was no statistically significant difference between the studied groups regarding the age, sex and BMI.
There were 60% of the studied cases in both groups had lobectomy, 30% had pnumonectomy and only 10% had Wedge resection.
There was non-significant difference in between TPVB group and ESPB groups as regard to VAS resting, VAS score with ambulation, heart rate .
There was a significant difference in between TPVB group and ESPB group according to map at 10 min after induction, intraop 30 min, intraop 1h, intraop 1.30h. intraop 2 h, postop 1h, postop 2h, postop 3h, postop 6, postop 9, postop 12h and postop 24h.
There was non-significant difference in between TPVB group and ESPB group according to respiratory rate.
The mean time of rescue bolus of bupivacaine in TPVB group was 360 ± 60 and in ESPB group was 600 ± 100 with significant difference in between.
There was a-significant difference in between TPVB group and ESPB as regard to Morphine consumption postoperative, Total bupivacaine Consumption.
SUMMARY
50
Only two patients (10%)from each group were not satisfied, and the remaining 18 (90%) were satisfied. There were 3 patients (15%) in TPVB group and 2 patients (10%) in ESPB group had intraoperative hypotension and 3 patients (15%) had PONV in TPVB and none in ESPB.