Paravertebral Block in Thoracotomy—Comparison between Single-Shot and Catheter Methods

摘要

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.