Regional Analgesia for Video-Assisted Thoracoscopic Surgery：Thoracic Paravertebral Block Is Recommended As the Optimal Technique

Abstract

Video-assisted thoracoscopic surgery (VATS) is less invasive than traditional open thoracotomy and improves patient outcomes. However, postoperative pain in such cases is unexpectedly severe.Effective postoperative analgesia is believed to reduce morbidity, accelerate recovery, and improve patient outcomes. Thoracic epidural anesthesia (TEA) has been commonly used for pain control after VATS. TEA is effective in achieving pain relief but has side effects, including urinary retention, postoperative nausea and vomiting, and hypotension. Because of these side effects, TEA has been questioned as the gold standard for pain management after VATS. In our institute, we performed thoracic paravertebral block (TPVB) as pain management for about 1,000 cases after VATS as an alternative technique to TEA and obtained good results. This article shows that TPVB is a safe and simple technique that can provide TEA-equivalent pain relief with fewer side effects than TEA. We therefore feel that TPVB is the ideal method for pain management after VATS.