Preemptive ultrasound-guided paravertebral block and immediate postoperative lung function

Area of Science:

• Anesthesiology and Pain Management
• Thoracic Surgery
• Pulmonary Medicine

Background:

• Video-assisted thoracoscopic surgery (VATS) necessitates effective postoperative pain management and respiratory support.
• Traditional intercostal blocks may offer suboptimal pain relief and lung function preservation.
• Preemptive regional anesthesia techniques are being explored to optimize outcomes.

Purpose of the Study:

• To compare the efficacy of preemptive ultrasound-guided thoracic paravertebral block (TPVB) versus surgeon-placed intercostal block (ICB) for postoperative respiratory function and pain control in VATS patients.
• To evaluate the impact of these blocks on pulmonary function tests and patient-reported pain scores.

Main Methods:

• A prospective cohort study involving 50 patients undergoing VATS.
• Patients received either ultrasound-guided TPVB preoperatively or ICB postoperatively.
• Pulmonary function (Forced Vital Capacity, FEV1, FEF25-75%) and pain (Visual Analog Scale) were assessed at baseline and 4 hours postoperatively.

Main Results:

• The TPVB group demonstrated significantly higher Forced Vital Capacity, FEV1, and FEF25-75% at 4 hours postoperatively (p < 0.001).
• TPVB resulted in significantly lower Visual Analog Scale pain scores at rest and during coughing (p < 0.05).
• Perioperative narcotic use was significantly reduced in the TPVB group (p = 0.04).

Conclusions:

• Ultrasound-guided TPVB is superior to ICB in preserving lung function post-VATS.
• TPVB provides superior immediate postoperative pain control compared to ICB.
• TPVB represents a valuable technique for optimizing recovery after thoracoscopic procedures.