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

IntroductionPatients 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 n...

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Main Authors: Jianhui Du, Luyao Wei, Jinxian He, Xia Xu, Lihong Hu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1554515/full
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author Jianhui Du
Luyao Wei
Jinxian He
Xia Xu
Lihong Hu
author_facet Jianhui Du
Luyao Wei
Jinxian He
Xia Xu
Lihong Hu
author_sort Jianhui Du
collection DOAJ
description IntroductionPatients 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.MethodsSixty 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.ResultsCompared 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).ConclusionCompared 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.Clinical trial registrationhttps://www.chictr.org.cn/, ChiCTR2000034726.
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spelling doaj-art-32c1a4074dd042b9a81ee70cee249e7a2025-08-20T03:10:06ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15545151554515Comparison of thoracoscopy-guided thoracic paravertebral block and patient-controlled intravenous analgesia for postoperative analgesia after uniportal thoracoscopic pulmonary wedge resection: a prospective randomized controlled trialJianhui Du0Luyao Wei1Jinxian He2Xia Xu3Lihong Hu4Department of Anesthesiology, Lihuili Hospital Affiliated to Ningbo University, Ningbo, ChinaDepartment of Anesthesiology, Lihuili Hospital Affiliated to Ningbo University, Ningbo, ChinaDepartment of Thoracic Surgery, Lihuili Hospital Affiliated to Ningbo University, Ningbo, ChinaDepartment of Anesthesiology, Lihuili Hospital Affiliated to Ningbo University, Ningbo, ChinaDepartment of Anesthesiology, Lihuili Hospital Affiliated to Ningbo University, Ningbo, ChinaIntroductionPatients 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.MethodsSixty 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.ResultsCompared 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).ConclusionCompared 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.Clinical trial registrationhttps://www.chictr.org.cn/, ChiCTR2000034726.https://www.frontiersin.org/articles/10.3389/fmed.2025.1554515/fulluniportal thoracoscopypulmonary wedge resectionthoracoscopic-guidedthoracic paravertebral blockpatient-controlled intravenous analgesicpostoperative analgesia
spellingShingle Jianhui Du
Luyao Wei
Jinxian He
Xia Xu
Lihong Hu
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
Frontiers in Medicine
uniportal thoracoscopy
pulmonary wedge resection
thoracoscopic-guided
thoracic paravertebral block
patient-controlled intravenous analgesic
postoperative analgesia
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic uniportal thoracoscopy
pulmonary wedge resection
thoracoscopic-guided
thoracic paravertebral block
patient-controlled intravenous analgesic
postoperative analgesia
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1554515/full
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