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The patients were randomly divided into two groups. In One-Level ESPB Group (n\u2009=\u200930) block was performed at the thoracal(T)5 level with the 30 ml 0.25% bupivacaine. In the Bi-Level ESPB Group (n\u2009=\u200930) block was performed at T4 and T6 levels by using 15 ml of 0.25% bupivacaine for each level. In the postoperative period, 50\u00a0mg dexketoprofen every 12 h and 1\u00a0g paracetamol every 8\u00a0h were given intravenously (IV). Patient-controlled analgesia (PCA) prepared with morphine was applied to the patients. 0.5\u00a0mg\/kg of tramadol was administered via IV for rescue analgesia. Visual analog scale (VAS) scores were recorded in the postoperative 1<jats:sup>st<\/jats:sup>, 2<jats:sup>nd<\/jats:sup>, 4<jats:sup>th<\/jats:sup>, 12<jats:sup>th<\/jats:sup>, 24<jats:sup>th<\/jats:sup>, and 48<jats:sup>th<\/jats:sup> -hours. The need for additional analgesics and side effects were recorded. In two groups, patients\u2019 demographics and postoperative hemodynamic data were recorded.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>VAS scores at resting were statistically significantly higher at the 1<jats:sup>st<\/jats:sup> (p: 0.002) and 4<jats:sup>th<\/jats:sup> -hour (p: 0.001) in the One-Level ESPB. When the groups were evaluated in terms of VAS coughing scores, the 4<jats:sup>th<\/jats:sup> -hour (p: 0.001) VAS coughing scores results were found to be statistically significantly higher in the One-Level ESPB group. In terms of VAS values evaluated during follow-up, the rates of VAS coughing score\u2009&gt;\u20093 values were found to be statistically significantly lower in the Bi-Level ESPB group (p: 0.011). There was no statistically significant difference between the groups in terms of side effects, morphine consumption, and additional analgesic use (p\u2009&gt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Adequate analgesia was achieved in the early postoperative period in the group treated with Bi-Level ESPB with similar morphine consumption and side effects. This may be an advantage, especially in the early postoperative period when the pain is quite intense.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-023-02232-8","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T06:01:33Z","timestamp":1691733693000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Comparison of the effects of one-level and bi-level pre-incisional erector spinae plane block on postoperative acute pain in video-assisted thoracoscopic surgery; a prospective, randomized, double-blind trial"],"prefix":"10.1186","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7653-6405","authenticated-orcid":false,"given":"Emine Nilg\u00fcn","family":"Zengin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2249-6521","authenticated-orcid":false,"given":"Musa","family":"Zengin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4104-6924","authenticated-orcid":false,"given":"H\u00fclya","family":"Yi\u011fit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1124-7861","authenticated-orcid":false,"given":"Hilal","family":"Sazak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumru","family":"\u015eekerci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-2213","authenticated-orcid":false,"given":"Ali","family":"Alag\u00f6z","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,8,11]]},"reference":[{"issue":"1","key":"2232_CR1","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1186\/s12871-022-01823-1","volume":"22","author":"L - Sun","year":"2022","unstructured":"Sun L, Mu J, Gao B, Pan Y, Yu L, Liu Y. 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