The comparison of ultrasound-guided thoracic paravertebral blockade and internal intercostal nerve block for non-intubated video-assisted thoracic surgery

Background To compare the safety and feasibility of ultrasound-guided thoracic paravertebral blockade (TPVB) and internal intercostal nerve block (IINB) for non-intubated video-assisted thoracic surgery (NIVATS). Methods Thirty-four patients who underwent NIVATS from April 2016 to May 2017 were retrospectively reviewed and divided into two groups consecutively according to local analgesia treatment, of which 20 patients received TPVB (P group) and the remaining 14 received IINB (I group). A Propensity Score Matching (PSM) analysis was performed to control the selection bias due to nonrandom assignment. Results The procedure of propensity scores yielded 2 matched cohorts of 14 patients. There were no significant differences between the two groups regarding gender, age, BMI, and surgical types (P>0.05). Blood-gas analysis 15 minutes after opening the chest showed significantly lower PaCO2 in the P group compared to the I group (P=0.004). The consumption of propofol from anesthesia induction to 15 minutes after opening the chest was also lower in the P group compared with the I group (P=0.012). There were no significant differences in the duration of surgery and visual analogue scale (VAS) pain scores between the two groups (P>0.05). Conclusions Ultrasound-guided TPVB can provide safe and reliable local anesthesia for NIVATS.