Article description

Summary:

• To compare the effects of programmed intermittent bolus infusion (PIBI), continuous thoracic paravertebral infusion (CTPI), and continuous intravenous infusion (CII) on postoperative analgesia in patients undergoing video-assisted thoracoscopic surgery (VATS)
• Prospective, randomized, controlled trial, including 90 patients ASA I-II.
• Postoperative analgesia was randomized to PIBI, CTPI, and CII.
• The primary outcome was the numeric rating scale (NRS) score at rest and during coughing at 1, 4, 24, and 48 hours after surgery. The secondary outcomes included the actual and effective numbers of patient-controlled analgesia (PCA), ropivacaine use, Ramsay sedation scale score, quality of recovery-15 (QoR-15) score, values of hemodynamic parameters at different periods, intraoperative consumption of anaesthetic drugs, and postoperative adverse events. Postoperatively, the NRS score was reduced in the PIBI group compared with the CTPI and CII groups at rest and during coughing (p < 0.05). The number of PCAs was significantly lower in the PIBI group compared with the CTPI and CII groups (p < 0.05). The QoR-15 score was noticeably higher in the PIBI group than in the CTPI and CII groups (p = 0.001 and p = 0.000, respectively). Compared to intercostal nerve blocks (ICBs), passive and dynamic pain scores were not significantly different from ESPBs but required significantly greater rescue analgesia.

Conclusions:

• PIBI outperformed CTPI and CII in inducing analgesia for postoperative pain in patients undergoing VATS.