TITLE:
Paravertebral Block in Thoracotomy—Comparison between Single-Shot and Catheter Methods
AUTHORS:
Petko Stefanovski
KEYWORDS:
Thoracic Paravertebral Block, Pain Management, VATS
JOURNAL NAME:
Surgical Science,
Vol.13 No.6,
June
13,
2022
ABSTRACT: Aim: Thoracic paravertebral block is increasingly
used as a method of postoperative analgesia in thoracic surgery. We aimed to
compare two different methods of implementation: paravertebral thoracic block
with a catheter placed in the epidural space, and a single injection of
anesthetic at the end of surgery. Methods: We
randomized 60 patients undergoing VATS, in 17 (group A) single-dose
paravertebral block, and in another 21 (group B) catheter technique and
postoperative infusion of local anesthetic were used, and in the latter, the
control group (C) of 22 patients, analgesia was performed according to a
standardized protocol with non-steroidal
analgesics and opioids as needed. In all patients, in the early postoperative 48 hours, we measured the intensity
of pain and opioid consumption. Results: There were no statistically
significant differences between the collected preoperative data in the three
groups of patients. There were no significant differences in subjective pain
sensations in the early postoperative period (up to 12 hours). However, the number of
opioids used was significantly lower in groups A and B compared to the control
group, and in group B (with catheter technique) after the 12th to 48th hour
after surgery there was almost no need for strong analgesics. Conclusion:
Continuous infusion of local anesthetic in the area of the surgical incision
provides much better pain relief than a single paravertebral block in the area
of the incision.