Effect of Paravertebral Block on the Outcomes of Patients Undergoing Video-Assisted Thoracic Surgery

Sunday, 30 July 2017: 11:15 AM

Myra I. Torres, MSN
Short Stay Unit, John Muir Health, Vallejo, CA, USA
Linda A. Minnich, BSN
Post- Anesthesia Care Unit, John Muir Health, Concord, CA, USA


The purpose of this study was to determine if there was a relationship between the introduction of paravertebral block pre-operatively and patient’s post-operative pain scores, length of urinary catheter use and length of hospital stay.


The study design is retrospective data collection of 40 patients undergoing Video-Assisted Thoracic Surgery (VATS) with wedge resection at a small community hospital in Northern California between March 2013 and March 2015. The decision on whether to apply paravertebral block was based on surgeon preference. All patients included in the study received the usual surgical pain regimen of systemic opioids. At the Post-anesthesia care unit, all patients receive systemic opioids using patient controlled analgesia (PCA) until post-op day 2.

Half of the patients (control group) did not receive the paravertebral block, while the other half received paravertebral block pre-operatively. Those who received paravertebral block had a continuous infusion from the pre-operative period up to 48 hours after surgery.

Convenience sampling was used. No patient was identified by name or MRN number. Permission to study was granted by the hospital nursing research committee Wilcoxon signed-rank test was used.


VATS patients who received paravertebral blocks reported lower pain scores from the afternoon of post-op day 2 until post op day 4 (p= 0.04 on post-op day 2, p=0.006 & p=0.08 on day 3, p=0.03 & 0.06 on day 4), had earlier urinary catheter removal (p= <0.001) and had shorter length of stay (p= 0.0017) compared to patients who did not receive paravertebral blockade. Patients had no demographic differences other than average body mass index (BMI), which was higher in the treatment group (p=0.006) and may have contributed to a surgeon’s decision on whether or not to use paravertebral blockade.


The study shows that paravertebral blockade in patients who are undergoing thoracic surgery with wedge resection can have beneficial patient outcomes such as decreased pain levels, shorter urinary catheter use and decreased hospital length of stay. All of these, in turn, may be factors in increasing patient satisfaction, preventing device-related infection, increasing hospital reimbursement and decreasing hospital costs.