IT IS WELL KNOWN that a thoracotomy incision is one of the most painful incisions
that a patient can experience. Pain control is crucial not only for humanitarian reasons
and patient satisfaction, but also for favorable outcomes in patients having open
thoracotomy procedures. A wide variety of modalities have been used to control post-thoracotomy
pain, including systemic analgesics, cryoanalgesia, intrapleural analgesia, and regional
techniques such as intercostal blockade, thoracic epidural analgesia (TEA), and paravertebral
block (PVB). TEA long has been considered the gold standard for post-thoracotomy pain
relief and has been accepted widely as the analgesic modality of choice for patients
undergoing open thoracic procedures.
1
Paravertebral block, a technique first described by Sellheim more than a century
ago, has gained popularity for post-thoracotomy pain control in recent years. Despite
this resurgence, TEA remains the most widely used analgesic modality, with 61% of
practitioners electing to place a thoracic epidural catheter versus 31% for paravertebral
blockade in one study.
2
In this review, the authors found that TEA remained superior to PVB for open thoracic
procedures.Key words
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Published online: September 16, 2015
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© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
