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    Comparative efficacy of erector spinae plane block versus surgeon-performed intraoperative intercostal nerve block in video-assisted thoracoscopic surgery: a retrospective analysis
    (Bmc, 2025) Kina, Soner; Batihan, Guntug; Turkan, Huseyin; Bektas, Yekta
    BackgroundVideo-assisted thoracoscopic surgery (VATS) offers reduced postoperative pain and faster recovery, yet optimal analgesia remains essential. Regional anesthesia techniques, such as the erector spinae plane (ESP) block and intercostal nerve block (ICNB), are commonly employed. This study compares preoperative ESP block with surgeon-performed intraoperative ICNB in VATS patients.MethodsIn this retrospective study, 82 patients (>= 18 years; ASA I-III) underwent elective VATS between January 2020 and December 2022 were analyzed. Forty patients received a postoperative ESP block and 42 an intraoperative ICNB. Primary outcomes included postoperative pain scores using the Visual Analog Scale, postoperative peak expiratory flow (PEF), postoperative IV opioid analgesic use, drainage time, and hospital length of stay.ResultsBaseline demographics were similar. VAS scores were comparable at postoperative 1, 3, 6, 12 and 24 h. At postoperative 48 h, the ICNB group had significantly lower VAS scores (4.17 +/- 1.03 vs. 4.78 +/- 1.03; p = 0.00987). No significant differences were observed in postoperative iv opioid analgesic use, drainage time or hospital stay.ConclusionsBoth techniques provide effective early analgesia in VATS, with ICNB showing prolonged pain relief. Further prospective studies are warranted.
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    Öğe
    Transbronchial EBUS-guided aspiration of a loculated pleural collection following right superior bilobectomy: a case report
    (Bmc, 2025) Batihan, Guntug; Topaloglu, Ihsan
    BackgroundPostoperative loculated pleural collections can mimic empyema and present diagnostic challenges, especially when transthoracic access is limited due to altered anatomy.Case presentationWe present the case of a 67-year-old male who developed a pleural collection six months after right superior bilobectomy for central squamous cell lung carcinoma. Due to mediastinal shift and limited transthoracic access, EBUS was used under LMA ventilation to access the loculated pleural pocket adjacent to the right paratracheal region. This unconventional but anatomically justified approach allowed safe sampling when standard ultrasound-guided thoracentesis was not feasible, demonstrating a minimally invasive diagnostic alternative in complex postoperative thoracic anatomies. A total of 15 cc pleural fluid was aspirated, which grew Streptococcus pneumoniae. The patient responded well to antibiotics and remains asymptomatic at 9 months.ConclusionsThis case highlights a novel application of EBUS in post-surgical thoracic anatomy, offering a minimally invasive alternative when conventional aspiration routes are inaccessible.