Background and Aims: Managing pain after thoracic surgery is crucial and the traditional methods have many adverse effects. We aimed to evaluate serratus anterior plane block (SAPB) and erector spinae plane block (ESPB) in acute pain control in thoracic cancer surgeries. Methods: This randomised controlled, triple-blind study was performed on 90 patients, between 18 and 70 years old, scheduled for elective thoracic cancer surgery. Patients were allocated into three equal groups: Control group: received sham ESPB and sham SAPB. SAPB group received SAPB (20 ml bupivacaine 0.5%) and sham ESPB. ESBP group received ESPB (20 ml bupivacaine 0.5%) and sham SAPB. Results: Postoperative morphine consumption was significantly lower in ESBP and SAPB groups than control group [ESPB (8.52 ± 4.29 mg) < SAPB (19.57 ± 7.63 mg) < control (36.37 ± 8.27 mg)] ( P < 0.001). Numerical rating scale pain score was comparable among the groups at rest, but was significantly lower at 30 min, 2, 4 h in ESPB and SAPB groups, than control group on coughing. The scores were better in SAPB compared to control group till 4 h. At 8, 12, 24 h, the difference between control and SAPB groups became insignificant, but it remained the least in ESPB group. Postoperative forced vital capacity and forced expiratory volume in the first second after 24 h were the best in ESPB group and better in SAPB group compared to the control group. Conclusion: Both ESPB and SAPB reduced intraoperative and postoperative opioid consumptions and postoperative dynamic pain scores with improved postoperative pulmonary functions in thoracic surgery with the ESPB being superior.

Background: As a result of the growing international prevalence of overweightness, following then, the proportion of obese people undergoing major surgery increased. Both obesity and laparoscopic cancer surgeries had physiological effect on the respiratory system. Various studies have shown that Dexmedetomidine improves both lung compliance and oxygenation. The goal of the work to compare the effect of two various doses of dexmedetomidine infusion intraoperative on the oxygenation and lung mechanics in obese underwent laparoscopic cancer surgeries. Materials and Methods: This randomized double-blinded, trial was performed on 70 cases who underwent laparoscopic pelviabdominal cancer surgery. Cases were categorized into 2 equal groups. Group A: was given 1 μg/kg body weight dexmedetomidine then 0.5 μg/kg/hour, and group B: received 0.5 μg/kg body weight then 0.3 μg/kg/hour. Dexmedetomidine was administered as a bolus following intubation, then infusion till the end of surgery. Arterial blood gases and lung mechanics were measured at baseline, 30, 60, 90,120 min, and end of surgery. Results: PaO2/FiO2 ratio at 90min, 120min, and the end of surgery and delta PaO2/FiO2 were significantly increased in group A than in group B (P = 0.045, 0.048, and 0.047, respectively). Dynamic compliance at 120 min and at end of surgery were significantly increased in group A in comparison to group B (P = 0.047 and 0.04, respectively). Conclusions: Dexmedetomidine at a higher dose provides better oxygenation, dynamic compliance, lower dead space in obese laparoscopic cancer patients.