A prospective, randomised comparison of continuous paravertebral block and continuous intercostal nerve block for post-thoracotomy pain

  • S Ouerghi
  • N Frikha
  • T Mestiri
  • B Smati
  • M.S Mebazaa
  • T Kilani
  • M.S Ben Ammar


Background: This study aimed to compare paravertebral block and continuous intercostal nerve block after thoracotomy.
Methods: 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.
Results: 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.
Conclusion: We found that continuous intercostal nerve block and paravertebral block were effective and safe methods for post-thoracotomy pain. 

Journal Identifiers

eISSN: 2220-1173
print ISSN: 2220-1181