A prospective randomized trial of continuous paravertebral infusion versus intravenous patient-controlled analgesia after thoracoscopic lobectomy for lung cancer

Since thoracoscopic lobectomy was introduced in 1990s, it has been regarded as a useful surgical option for early-stage lung cancer because it could reduce operative morbidities as compared with open lobectomy. However, some patients still complain of severe acute pain after thoracoscopic lobectomy, and the incidence of chronic pain was reported up to 30% (1,2). Penetration of the chest wall by trocars, torque at trocar, and compression of the intercostal nerves have all been suggested to cause pain after thoracoscopic lobectomy (3,4). Current analgesic options for acute pain include thoracic epidural analgesia, intravenous patient-controlled analgesia (iv-PCA), thoracic paravertebral block, and continuous paravertebral infusion (c-PVI) of local anesthetics.