Comparison of Thoracoscopy-Guided Thoracic Paravertebral Block and Patient-Controlled Intravenous Analgesia for Postoperative Analgesia after Uniportal Thoracoscopic Pulmonary Wedge Resection: A Prospective Randomized Controlled Trial

Jianhui DuLuyao WeiJinxian HeXia XuLihong Hu^*

• Ningbo Medical Centre Lihuili Hospital, Ningbo, China

Introduction: Patients often experience persistent, intense pain following Uniportal Thoracoscopic Pulmonary Wedge Resection (UTPWR). This pain is usually intervened with Patient-Controlled Intravenous Analgesia (PCIA) or Thoracoscopic-Guided Thoracic Paravertebral Block (TG-TPB), a novel peripheral nerve block technique. Herein, we compared the analgesic effects of TG-TPB and PCIA post-UTPWR.Methods: Sixty patients allocated into two groups: T and P. Group T patients were administered TG-TPB with 20 ml 0.375% ropivacaine at the fourth intercostal plane before sealing the chest, and connected to a PCIA pump containing 0.9% Sodium Chloride (NaCl).Group P patients received TG-TPB with 20 ml 0.9% NaCl and were connected to a PCIA pump containing sufentanil. The Visual Analogue Scale (VAS) scores were recorded at 2, 6, 12, 24, 36, and 48 h postoperatively. Data on sufentanil consumption, number of PCIA presses, number of rescue analgesia interventions, Adverse Reactions (ARs), and the 15-item Quality of Recovery Scale (QoR-15) scores were also recorded within 24 h postoperatively.Results:Compared to the P group, the T group showed lower VAS scores at 2, 6, 12, and 24 h postoperatively, as well as lower sufentanil consumption levels, number of PCIA presses, number of rescue analgesia interventions, and ARs incidences within 24 h postoperatively (all P<0.05). Furthermore, the T group showed higher QoR-15 scores within 24 h postoperatively than the P group (90.5±7.3 vs. 76.6±6.2; P<0.001).Compared to PCIA, TG-TPB exerted a better analgesic effect post-UTPWR, with less opioid drug use, fewer ARs, and a significantly better recovery quality within 24 h postoperatively.