[Efficacy of Ultrasound-guided Thoracic Paravertebral Block Compared with the Epidural Analgesia in Patients Undergoing Video-assisted Thoracoscopic Surgery]

Thoracic paravertebral block (TPVB) has proven to be safer by using ultrasound imaging. This prospective randomized study was designed to investigate postoperative pain relief and intraoperative hemodynamics in patients undergoing ultrasound-guided TPVB or epidural analgesia.Twelve patients scheduled for thoracoscopic surgery for lung cancer were randomly divided into two groups and received ultrasound guided TPVB (N=6) or epidural analgesia (N=6). Both groups received postoperative analgesia with continuous infusion of 0.2% ropivacaine 6 ml · hr(-1) via paravertebral or epidural block. Postoperative numeric rating score (NRS) and the data of intraoperative hemodynamics were collected.In comparison with the epidural group, the level of NRS was higher in the TPVB group at 12 hr (4.5±1.05 vs 2.7±0.82, P0.01), and 24 hr (4.5±1.05 vs 2.7±0.82, P0.01) after surgery. In the TPVB group, the intraoperative amount of transfusion was smaller (1,331±147 ml vs 1,693±162 ml, P0.01) and the lowest systolic pressure was higher (87±4.56 mmHg vs 73±4.34 mmHg, P0.01) than that of the epidural group.Ultrasound guided TPVB was performed affecting hemodynamics less than the epidural anesthetic. There was less postoperative analgesic effect on TPBV than on epidural analgesia after thora- coscopic surgery when continuously infusing 0.2% ropivacaine 6 ml · hr(-1).