Date of this Version

11-25-2025

Document Type

DNP Project

Rights

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Abstract

Background

The serratus anterior plane block (SAPB) and erector spinae plane block (ESPB) are viable options for post-VATS pain relief, often chosen based on provider preference. SAPB effectively addresses lateral thoracic incisions and chest tubes, offering benefits such as simplicity and safety, making it popular in VATS. ESPB provides broader somatic and visceral analgesia by targeting the thoracic nerve rami. This study aims to compare which block more effectively reduces postoperative opioid use, pain scores, timing of rescue analgesia, and complications.

Methods

A literature review compared the analgesic effectiveness of SAPB and ESPB in adults undergoing VATS, showing that ESPB consistently reduced opioid use and improved postoperative pain, especially in the first 24 hours. An online educational module was created to present these findings to anesthesia providers, accompanied by pre- and post-surveys to assess knowledge gain. The module was distributed anonymously to alumni of a South Florida University Nurse Anesthesia program, and the collected data was analyzed to evaluate participant learning. Results Twenty-four anesthesia providers consented to and started the survey, with 21 completing it. The pre-test showed 82% correctly identified that ESPB reduces opioid use, increasing to 90% after the educational module. All post-test questions showed improved knowledge except one, which stayed at 86%. Overall, the results indicate increased understanding of ESPB and SAPB targets, efficacy, and evidence-based practices for postoperative pain management in VATS.

Discussion

The educational intervention improved anesthesia providers’ knowledge of ESPB and SAPB for VATS, with post-test scores rising in all areas. This demonstrates the module’s effectiveness in clarifying the anatomy of blocks, analgesic mechanisms, and indications. The steady improvement aligns with evidence of ESPB’s broader dermatomal coverage and opioid-sparing benefits, reflecting current evidence. The study indicates that concise, evidence-based education can translate research into practice and support opioid-conscious analgesia. Limitations include a small sample size and a lack of a control group, which may limit generalizability.

Conclusion

This project enhanced anesthesia providers’ understanding of ESPB and SAPB through targeted education. Post-test results showed significant improvement, validating evidence-based teaching. Findings indicate ESPB offers better pain control and reduces opioid use after VATS compared to SAPB. The study emphasizes the importance of ongoing education to implement research into practice, promoting ESPB in multimodal analgesia and ERAS pathways. Further research with larger, diverse groups is needed to evaluate long-term knowledge retention, clinical impact, and patient outcomes.

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