{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:07:53Z","timestamp":1783008473260,"version":"3.54.5"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T00:00:00Z","timestamp":1698105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Paravertebral block (PVB) has been increasingly popular for postoperative analgesia. However, few studies estimated the efficacy and safety of multiple PVB using thoracoscope-assisted technique for intraoperative analgesia and postoperative pain management for video-assisted thoracoscopic lobectomy (VATS LOBECTOMY).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 120 patients scheduled to undergo VATS LOBECTOMY were randomly assigned into two groups: a placebo group and a PVB group in a ratio of 1:2. Thoracoscopic-guided multi-point PVB was carried out with 0.5% ropivacaine (PVB group) or 0.9% NaCl (placebo group) at the beginning and the end of surgery. The primary endpoint was consumption of intraoperative opioid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Consumption rate of intraoperative opioids was significantly lower in the PVB group (878.14\u2009\u00b1\u200998.37 vs. 1,432.20\u2009\u00b1\u2009383.53 for remifentanil; 123.83\u2009\u00b1\u200917.98 vs. 266.42\u2009\u00b1\u200941.97 for fentanyl). Postoperatively, significantly longer duration of using patient-controlled intravenous analgesia for the first time, reduced times of analgesic pump pressing, and less rescue analgetic consumption were observed in the PVB group. Visual analog scale scores at rest and during exercising were significantly lower in the PVB group at all time points within the first 48\u2005h after surgery. The PVB group was also associated with significantly higher total QoR-40 scores and lower incidence of analgesia-related adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Thoracoscopic-guided multiple PVB was a simple and effective technique in controlling pain both intra- and postoperatively for VATS LOBECTOMY. It was also associated with the absence of detrimental effects attributed to opioid overuse and benefits of the early resumption of activity and physical function recovery. Therefore, this regional anesthesia technique should be advocated as part of a multimodal analgesia protocol for VATS LOBECTOMY.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2023.1267477","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T01:55:38Z","timestamp":1698198938000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy and safety of thoracoscopic-guided multiple paravertebral block for video-assisted thoracoscopic lobectomy surgery: a randomized blinded controlled study"],"prefix":"10.3389","volume":"10","author":[{"given":"Zhixiong","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingshui","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangqing","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghua","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinhui","family":"Ke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaohua","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1738","DOI":"10.21037\/jtd.2019.05.26","article-title":"Electronic chest tube drainage devices and low suction following video-assisted thoracoscopic pulmonary lobectomy","volume":"11","author":"Bowman","year":"2019","journal-title":"J Thorac Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1093\/icvts\/ivy231","article-title":"Surgical wound-site inflammation: video-assisted thoracic surgery versus thoracotomy","volume":"28","author":"Menna","year":"2019","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B3","first-page":"393","article-title":"Analgesia in thoracic surgery: review","volume":"75","author":"De Cosmo","year":"2009","journal-title":"Minerva Anestesiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1093\/bja\/aen360","article-title":"Major complications of central neuraxial block: report on the Third National Audit Project of the Royal College of Anaesthetists","volume":"102","author":"Cook","year":"2009","journal-title":"Br J Anaesth"},{"key":"B5","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.thorsurg.2020.03.001","article-title":"Pain management in thoracic surgery","volume":"30","author":"Marshall","year":"2020","journal-title":"Thorac Surg Clin"},{"key":"B6","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1111\/anae.15256","article-title":"The role of regional anaesthesia and multimodal analgesia in the prevention of chronic postoperative pain: a narrative review","volume":"76","author":"Chen","year":"2021","journal-title":"Anaesthesia"},{"key":"B7","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1093\/bja\/ael360","article-title":"Pain relief after thoracotomy: is epidural analgesia the optimal technique?","volume":"98","author":"Ng","year":"2007","journal-title":"Br J Anaesth"},{"key":"B8","doi-asserted-by":"publisher","first-page":"231","DOI":"10.4097\/kja.21330","article-title":"Regional analgesia techniques for video-assisted thoracic surgery: a frequentist network meta-analysis","volume":"75","author":"Jo","year":"2022","journal-title":"Korean J Anesthesiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1213\/ANE.0000000000001117","article-title":"Ultrasound-guided thoracic paravertebral blockade: a retrospective study of the incidence of complications","volume":"122","author":"Pace","year":"2016","journal-title":"Anesth Analg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.1111\/1759-7714.13291","article-title":"Does the length of uniportal video-assisted thoracoscopic lobectomy affect postoperative pain? 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