Sensory Anesthesia Achieved Through Different Paravertebral Block Approaches for Post-Op Pain Management After VATS Lung Resection
Sensory Anesthesia Achieved Through Different Paravertebral Block Approaches for Post-Operative Pain Management After Videothoracoscopic Lung Resection
Centre hospitalier de l'Université de Montréal (CHUM)
90 participants
Sep 10, 2025
OBSERVATIONAL
Conditions
Summary
Video-assisted thoracoscopic lung resection (VATS) is a minimally invasive surgical approach frequently used in the treatment of lung cancers. The most commonly used analgesic technique for this surgery is the paravertebral block with a single peroperative injection of local anesthetic. However, a recent study conducted at our institution revealed that this approach provided less relief than expected in some patients. In light of these results, it becomes crucial to distinguish between technical failures (absence of sensitive anesthesia) and the intrinsic limits of the chosen regional analgesia technique (pain originating from an unanesthetized area or pain despite the presence of sensitive anesthesia) in order to better relieve patients. This study aims to objectively assess the areas of anesthesia obtained through three methods of paravertebral block to evaluate their respective performance and optimize post-VATS analgesic management.
Eligibility
Inclusion Criteria2
- Patients aged 18 years and older
- American Society of Anesthesiologists (ASA) score 1-3
Exclusion Criteria7
- Contraindication to the paravertebral block (coagulopathy, use of anticoagulants or antiplatelet agents other than aspirin that have not been stopped according to hospital guidelines, thoracoscopic visualization of the paravertebral space expected to be difficult or impossible, anterior spinal surgery with potential discontinuity of the paravertebral space)
- Epidural analgesia preferred (high risk of thoracotomy, marginal lung function)
- Surgical criteria: conversion to thoracotomy necessary and thoracic epidural or other form of regional analgesia implemented post-operatively
- Known allergy to local anesthetics
- Language barrier, psychiatric, physical or mental condition making pain assessment impossible despite prior education
- Pregnancy
- Patient refusal to participate
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Interventions
In the recovery room, a member of the research team will come to assess the presence of hypoesthesia (loss of sensation) of the thorax using ice and a Von Frey filament applied at three different sections: midscapular, midaxillary and midclavicular.
Locations(1)
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NCT07063602