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The Effects of Programmed Intermittent Paravertebral Bolus Infusion on Postoperative Analgesia in Patients Undergoing Video-Assisted Thoracoscopic Surgery: A Prospective, Randomized, Controlled Study.

OBJECTIVES
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).


DESIGN
Prospective, randomized, controlled.


SETTING
The operating room, post-anesthesia care unit, and patient ward of a university hospital.


PARTICIPANTS
Ninety patients with American Society of Anesthesiologists (ASA) physical status Ι to II, aged 35-70 years, and scheduled for VATS.


INTERVENTIONS
Postoperative analgesia was randomized to PIBI, CTPI, and CII.


MEASUREMENTS AND MAIN RESULTS
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 anesthetic 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 noticeably increased in the PIBI group compared with the CTPI and CII groups (p = 0.001 and p = 0.000, respectively).


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