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Related Experiment Video

Updated: Jun 3, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery

Non-Intubated Video-Assisted Thoracoscopic Surgery

Published on: May 26, 2023

Multiple nerve blocks after video-assisted thoracic surgery (VATS).

Luca Milone¹, Donna Edmondson, Abraham Lebenthal

¹Department of Surgery, Division of Thoracic Surgery, Fox Chase Cancer Center, Philadelphia, PA, USA.

Surgical Endoscopy

|March 19, 2011

Summary

Subpleural catheters offer effective pain control after video-assisted thoracic surgery (VATS) lobectomy, reducing narcotic use within 24 hours. This technique provides comparable pain relief to standard methods with fewer side effects.

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Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

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Published on: June 25, 2013

Area of Science:

Thoracic Surgery
Pain Management
Anesthesiology

Background:

Traditional pain management after VATS lobectomy involves epidural analgesia or systemic narcotics, often with associated side effects.
A novel technique for safely placing subpleural catheters to administer multiple nerve blocks is presented.

Purpose of the Study:

To describe a technique for subpleural catheter placement for post-VATS lobectomy analgesia.
To compare the efficacy of subpleural catheter analgesia with standard post-operative pain control protocols.

Main Methods:

Subpleural catheters were placed using a specialized introducer after VATS wedge resection, guided by thoracoscope.
The catheter was advanced between the thoracic pleura and ribs, utilizing blunt and hydro dissection.
Sixty-four patients were evaluated, with propensity weighting creating matched groups for analysis (29 patient-controlled analgesia, 35 subpleural catheter).

Main Results:

The subpleural catheter (SC) group showed significantly decreased mean total morphine dose and mean total morphine dose/BMI in the 0-24 hour period compared to the patient-controlled analgesia (PCA) group.
Specifically, mean total morphine was 27.8 in SC vs. 38.1 in PCA (P = 0.024), and mean total morphine/BMI was 0.79 in SC vs. 1.15 in PCA (P = 0.024).
No significant difference in complication rates was observed between the two groups.

Conclusions:

Subpleural local anesthetic infusion via catheters provides effective pain control after VATS lobectomy.
This technique resulted in reduced narcotic utilization within the first 24 hours post-surgery compared to standard PCA narcotic analgesia.
The subpleural catheter approach offers a promising alternative for post-VATS lobectomy pain management.