oa Southern African Journal of Anaesthesia and Analgesia - A prospective, randomised comparison of continuous paravertebral block and continuous intercostal nerve block for post-thoracotomy pain : original research

Volume 14, Issue 6
  • ISSN : 2220-1181
  • E-ISSN: 2220-1173



This study aimed to compare paravertebral block and continuous intercostal nerve block after thoracotomy.

Forty-six adult patients undergoing elective posterolateral thoracotomy were randomised to receive either a continuous intercostal nerve blockade or a paravertebral block. Opioid consumption and postoperative pain were assessed for 48 hours. Pulmonary function was assessed by forced expiratory volume in 1 s (FEV1) recorded at 4 hours intervals.
With respect to the objective visual assessment (VAS), both techniques were effective for post thoracotomy pain. The average VAS score at rest was 29±10mm for paravertebral block and 31.5±11mm for continuous intercostal nerve block. The average VAS score on coughing was 36±14mm for the first one and 4 ±14mm for the second group. Pain at rest was similar in both groups. Pain scores on coughing were lower in paravertebral block group at 42 and 48 hours. Post-thoracotomy function was better preserved with paravertebral block. No difference was found among the two groups for side effects related to technique, major morbidity or duration of hospitalisation.
We found that continuous intercostal nerve block and paravertebral block were effective and safe methods for post-thoracotomy pain.

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