Paravertebral Analgesia in Video-Assisted Thoracic Surgery: A New Hybrid Technique of Catheter Placement for Continuous Anesthetic Infusion

Abstract

Advantages of paravertebral analgesia in thoracotomy include the absence of morphine side effects and the lack of contraindications. We introduce a new technique for paravertebral catheter placement during video-assisted thoracic surgery. The catheter is placed in the same intercostal space as the camera port. Anesthetic is injected to reach the parietal pleura. The catheter is inserted through the needle and pushed until the paravertebral space is reached. Postoperative analgesia is performed by a continuous infusion of local anesthetics. Our technique is safe and easy to perform and avoids opioid use. It works differently from intercostal analgesia and paravertebral blocks.

Keywords

paravertebral analgesia - VATS - contraindications - lung cancer

• References

• 1 Raveglia F, Rizzi A, Leporati A, Di Mauro P, Cioffi U, Baisi A. Analgesia in patients undergoing thoracotomy: epidural versus paravertebral technique. A randomized, double-blind, prospective study. J Thorac Cardiovasc Surg 2014; 147 (1) 469-473
• 2 Fibla JJ, Molins L, Mier JM, Sierra A, Carranza D, Vidal G. The efficacy of paravertebral block using a catheter technique for postoperative analgesia in thoracoscopic surgery: a randomized trial. Eur J Cardiothorac Surg 2011; 40 (4) 907-911
• 3 Forcella D, Pompeo E, Coniglione F, Gatti A, Mineo TC. A new technique for continuous intercostal-intrapleural analgesia in videothoracoscopic surgery. J Thorac Cardiovasc Surg 2009; 137 (1) e48-e49
• 4 Wildgaard K, Petersen RH, Hansen HJ, Møller-Sørensen H, Ringsted TK, Kehlet H. Multimodal analgesic treatment in video-assisted thoracic surgery lobectomy using an intraoperative intercostal catheter. Eur J Cardiothorac Surg 2012; 41 (5) 1072-1077