Paravertebral vs. Epidural Anesthesia for Video-Assisted Thoracoscopic Surgery: A Randomized Trial

Although video assisted thoracoscopic surgery (VATS) is associated with less pain than open surgery, there are still several complications that arise due to poor postoperative control with VATS. Epidural analgesia has traditionally been considered the gold standard for pain control, however regional analgesia like paravertebral blocks (PVB) are increasingly being used. The authors explore the use of patient controlled PVB analgesia compared to epidural analgesia as part of a randomized controlled trial. Interestingly, with the PVB, the authors found no additional puncture pain, shorter time duration for catheter placement, and overall reduced failure rate of catheter placement. Hence, PVB is another viable and effective tool that clinicians have at their disposal to optimize pain control after VATS.