Continuous Paravertebral Nerve Blockade for Postoperative Analgesia after Video-Assisted Thoracoscopic Surgery and Chemical Pleurodesis in Children-A Case Series

Abstract

Study Objective: It is to compare continuous thoracic paravertebral blockade and thoracic epidural catheters for postoperative pain after VATS and chemical pleurodesis in children. Design: Case series, retrospective chart review. Setting: Children’s Hospital of University of Pittsburgh Medical Center. Patients: We studied seventeen (17) pediatric patients who underwent VATS with chemical pleurodesis. Interventions: Fourteen children (14) had continuous thoracic paravertebral blockade and three children (3) had thoracic epidural catheters. Measurements and main results: Postoperative pain scores and consumption of analgesics were compared during the first 48 hours after surgery. Total length of hospital stay and complications secondary to analgesics and regional analgesia were analyzed and compared. Median pain scores were similar with P-values ranging from P = 0.13-0.76. Opioid consumption was not significantly different, with P-values for opioid morphine equivalency ranging from P= 0.13-0.96. Length of stay was significantly shorter for thoracic paravertebral group (3.86, SD±0.77) than for thoracic epidural group (5.00, SD±1.00) (P= 0.04). The rate of complications was low; frequency of nausea /emesis (P= 0.16) and itching (P= 0.60) was similar between groups.