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Purpose <p>The purpose of this study was to compare the postoperative analgesic outcomes of ultrasound-guided single-shot, ultrasound-guided continuous, or surgeon-performed direct-vision single-shot approaches to paravertebral block (PVB).</p> Methods <p>We retrospectively analyzed the data of the adults who underwent video-assisted thoracoscopic surgery (VATS) for lung resection at a university hospital. They were categorized into those who underwent ultrasound-guided single-shot PVB (PVB-US), ultrasound-guided continuous PVB with catheter infusion (PVB-US-Cath), and surgeon-performed intraoperative single-shot PVB under thoracoscopic visualization (PVB-VATS). The primary outcome was the number of rescue analgesic administrations within 24&#xa0;h of admission to the post-anesthesia care unit (PACU). The secondary outcomes were rescue analgesic use within 24–48&#xa0;h and pain scores at PACU admission and on the mornings of postoperative days (PODs) 1 and 2.</p> Results <p>Of the 489 eligible patients, the data of 385 were included in the final analysis (PVB-US, n = 53; PVB-US-Cath, n = 249; PVB-VATS, n = 83). The median (IQR) numbers of rescue analgesic doses within 24&#xa0;h for the PVB-US, PVB-US-Cath, and PVB-VATS groups were 1 (1–3), 2 (1–3), and 2 (0–3), respectively (<i>p</i> = 0.6880). Rescue analgesic use during 24–48&#xa0;h and NRS pain scores at the PACU and on PODs 1 and 2 did not significantly differ between the groups.</p> Conclusion <p>This study found no statistically significant differences in the postoperative analgesic outcomes of the ultrasound-guided single-shot, ultrasound-guided continuous, and surgeon-performed direct-vision single-shot PVB techniques for VATS. Given the predominantly mild and short-lived nature of pain after VATS, a technically simple single-shot strategy may offer an optimal balance between efficacy, feasibility, and procedural efficiency.</p>

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Comparison of paravertebral block techniques for postoperative analgesia after video-assisted thoracoscopic surgery for lung cancer: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年1月6日

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  • Hazuki Nakamura,
  • Shinya Suzuki,
  • Kanae Karita,
  • Akira Motoyasu,
  • Kiyoshi Moriyama,
  • Hiroyuki Seki

摘要

Purpose

The purpose of this study was to compare the postoperative analgesic outcomes of ultrasound-guided single-shot, ultrasound-guided continuous, or surgeon-performed direct-vision single-shot approaches to paravertebral block (PVB).

Methods

We retrospectively analyzed the data of the adults who underwent video-assisted thoracoscopic surgery (VATS) for lung resection at a university hospital. They were categorized into those who underwent ultrasound-guided single-shot PVB (PVB-US), ultrasound-guided continuous PVB with catheter infusion (PVB-US-Cath), and surgeon-performed intraoperative single-shot PVB under thoracoscopic visualization (PVB-VATS). The primary outcome was the number of rescue analgesic administrations within 24 h of admission to the post-anesthesia care unit (PACU). The secondary outcomes were rescue analgesic use within 24–48 h and pain scores at PACU admission and on the mornings of postoperative days (PODs) 1 and 2.

Results

Of the 489 eligible patients, the data of 385 were included in the final analysis (PVB-US, n = 53; PVB-US-Cath, n = 249; PVB-VATS, n = 83). The median (IQR) numbers of rescue analgesic doses within 24 h for the PVB-US, PVB-US-Cath, and PVB-VATS groups were 1 (1–3), 2 (1–3), and 2 (0–3), respectively (p = 0.6880). Rescue analgesic use during 24–48 h and NRS pain scores at the PACU and on PODs 1 and 2 did not significantly differ between the groups.

Conclusion

This study found no statistically significant differences in the postoperative analgesic outcomes of the ultrasound-guided single-shot, ultrasound-guided continuous, and surgeon-performed direct-vision single-shot PVB techniques for VATS. Given the predominantly mild and short-lived nature of pain after VATS, a technically simple single-shot strategy may offer an optimal balance between efficacy, feasibility, and procedural efficiency.