Single- versus Multiple-Injection Intertransverse Process Block for VATS: A Randomized Trial on Dermatomal Sensory...

Area of Science:

• Anesthesiology
• Pain Management
• Thoracic Surgery

Background:

• The intertransverse process (ITP) block is used for chest wall analgesia.
• Optimal injection techniques for the ITP block are not well-established.

Purpose of the Study:

• This study compared the efficacy of single versus multiple injections of the ITP block.
• The hypothesis was that multiple injections would provide superior sensory blockade for chest wall analgesia.

Main Methods:

• Forty patients undergoing video-assisted thoracic surgery were randomized.
• Patients received either a single (30 mL) or multiple (10 mL x 3) ultrasound-guided ITP block.
• The primary outcome was dermatomal sensory changes; secondary outcomes included block performance time and postoperative pain.

Main Results:

• No significant difference in sensory blockade was observed between single and multiple ITP injections (p=0.91).
• The single-injection technique had a significantly shorter block performance time (p=0.01).
• Postoperative pain intensity and intraoperative hypotension rates were similar between groups.

Conclusions:

• Single and multiple ITP blocks demonstrate comparable sensory blockade and analgesic effects.
• The single-injection technique's shorter performance time suggests potential practical advantages.
• Further large-scale studies are needed to confirm equivalence and guide definitive recommendations for ITP block techniques.