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Serratus posterior intercostal plane block (SPSIPB) is a novel periparavertebral block. It provides anterolateral posterior chest wall analgesia. It is an interfascial plane block, performed under ultrasound guidance, and the visualization of landmarks is easy. It is performed deep into the serratus posterior superior muscle at the level of the third rib. Until now, there have been case reports about the usage of single-shot SPSIPB, but there are no reports about the usage of the block catheterization technique of SPSIPB. Continuous infusion from a catheter of interfascial plane blocks is important for postoperative analgesia management after painful surgeries such as thoracic and cardiac surgeries. Thus, we performed SPSIPB catheterization in a patient who underwent right atrial mass excision with minimally invasive thoracotomy surgery. Here, we present our successful analgesic experience with continuous SPSIPB in this case report. [ABSTRACT FROM AUTHOR]

To test the hypothesis that thoracic epidural anesthesia and analgesia (TEA) reduces the incidence of chronic postoperative pain (CPSP) after video-assisted thoracoscopic surgery (VATS). A single-center, single-blind, randomized controlled trial was conducted. The study was conducted in the operating room, with follow-up assessments performed in the ward. Telephone was used to follow the long-term outcomes. 231 patients ≥18 years of age and scheduled for VATS. Patients were randomized into two groups, including an epidural block (EPI) group (general anesthesia with patient-controlled epidural analgesia) and a general anesthesia with patient-controlled intravenous analgesia (PCIA) group. The primary endpoint was the incidence of CPSP at 3 months postoperatively. CPSP data, including acute pain, neuropathic pain, depression, and side effects, were collected at 3 and 6 months postoperatively through telephone follow-up. A total of 231 patients were analyzed, including 114 in the PCIA group and 117 in the EPI group. Sixty-six patients (56.4 %) in the PCIA group and 33 patients (28.9 %) in the EPI group experienced chronic pain at 3 months postoperatively. The odds ratio (OR) was 0.31 (95 % confidence interval [CI], 0.18 to 0.54; P < 0.0001). After adjusting for confounding factors, the adjusted OR was 0.28 (95 % CI, 0.16 to 0.50, P < 0.001). Six months postoperatively, 50 (42.7 %) and 17 (14.9 %) patients in the PCIA and EPI groups, respectively, were diagnosed with CPSP (P < 0.0001). • Thoracic epidural analgesia can reduce the incidence of chronic pain after VATS. • Thoracic epidural analgesia can reduce the severity of acute pain after 24 h of VATS. • Thoracic epidural analgesia should be superior considered for patients with high risks of CPSP. [ABSTRACT FROM AUTHOR]