Effect of Single-Injection Thoracic Paravertebral Block via the Intrathoracic Approach for Analgesia After Single-Port Video-Assisted Thoracoscopic Lung Wedge Resection: A Randomized Controlled Trial

Abstract

Introduction Pain is still severe after single-port video-assisted thoracoscopic (SPVAT) lung wedge resection. We observed the effect of single-injection thoracic paravertebral block (TPB) via the intrathoracic approach for analgesia after SPVAT lung wedge resection. Methods Sixty patients undergoing SPVAT lung wedge resection were randomly divided into a control group and an observation group. All patients underwent TPB via the intrathoracic approach at the T4 level with a scalp needle before closing the chest. The patients in the observation group received 20\xa0ml 0.375% ropivacaine at the T4 level, and the patients in the control group received 20\xa0ml of 0.9% saline. A patient-controlled intravenous analgesic (PCIA) pump with sufentanil was attached to all patients after surgery. The sufentanil consumption and number of PCIA presses in the first 24\xa0h after surgery were recorded. The visual analogue scale (VAS) scores (during rest and coughing) were recorded at 6\xa0h, 12\xa0h, 24\xa0h, and 36\xa0h after surgery. The incidence of adverse reactions after surgery were recorded. Results The sufentanil consumption in the observation group was significantly lower than that in the control group (34.2\u2009±\u20091.9\xa0µg vs. 52.3\u2009±\u20092.3\xa0µg; P \u2009<\u20090.001). The VAS score at 6, 12, and 24\xa0h after surgery, the incidence of adverse reactions after surgery in the observation group were significantly lower than those in the control group (all P \u2009<\u20090.05). The number of PCIA presses in the observation group was significantly lower than that in the control group [0 (0–0) times vs. 3 (2–4) times, P \u2009<\u20090.001]. Conclusions Single-injection TPB via the intrathoracic approach under thoracoscopic direct vision is easy to perform and can effectively alleviate postoperative pain after SPVAT lung wedge resection, with fewer adverse reactions. Trial Registration ChiCTR2000034726.