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Area of Science:

  • Anesthesiology
  • Thoracic Surgery
  • Pain Management

Background:

  • Paravertebral block (PVB) is an effective method for managing postoperative pain following thoracotomy.
  • This study investigates patient-controlled PVB versus intravenous patient-controlled analgesia (PCA) for 3-port single-intercostal video-assisted thoracic surgery.

Purpose of the Study:

  • To compare the efficacy and safety of patient-controlled PVB against intravenous PCA for postoperative pain control.
  • To evaluate pain levels, rescue medication requirements, and adverse events in patients undergoing video-assisted thoracic surgery.

Main Methods:

  • A randomized study involving 171 patients undergoing single-intercostal video-assisted thoracic surgery.
  • Patients were allocated to either patient-controlled PVB or intravenous PCA groups.
  • Pain was assessed using the visual analog score, with intramuscular dezocine as rescue medication.

Main Results:

  • No significant difference in mean visual analog scores between PVB and PCA groups (p = 0.115).
  • The PVB group required significantly lower cumulative dezocine doses (21.7 mg vs 30.9 mg, p = 0.001).
  • PVB group showed significantly lower frequencies of severe vomiting (p = 0.003) and hypotension (p = 0.005).

Conclusions:

  • Patient-controlled PVB provides effective pain relief for video-assisted thoracic surgery.
  • PVB leads to reduced reliance on rescue analgesics and fewer adverse effects compared to PCA.
  • PVB is a beneficial alternative for postoperative pain management in this patient population.