• Wei Liu, Fei Wang, Taijun Luo, Hongtao Zhang, Guangkuo Gao, Tao Liu, Yang Liu, and Shaofa Xu.
• Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, Beijing, China.
• J. Cardiothorac. Vasc. Anesth. 2022 Sep 1; 36 (9): 3637-3644.

ObjectivesTo compare the effects of programmed intermittent bolus infusion (PIBI), continuous thoracic paravertebral infusion (CTPI), and continuous intravenous infusion (CII) on postoperative analgesia in patients undergoing video-assisted thoracoscopic surgery (VATS).DesignProspective, randomized, controlled.SettingThe operating room, post-anesthesia care unit, and patient ward of a university hospital.ParticipantsNinety patients with American Society of Anesthesiologists (ASA) physical status Ι to II, aged 35-70 years, and scheduled for VATS.InterventionsPostoperative analgesia was randomized to PIBI, CTPI, and CII.Measurements And Main ResultsThe primary outcome was the numeric rating scale (NRS) score at rest and during coughing at 1, 4, 24, and 48 hours after surgery. The secondary outcomes included the actual and effective numbers of patient-controlled analgesia (PCA), ropivacaine use, Ramsay sedation scale score, quality of recovery-15 (QoR-15) score, values of hemodynamic parameters at different periods, intraoperative consumption of anesthetic drugs, and postoperative adverse events. Postoperatively, the NRS score was reduced in the PIBI group compared with the CTPI and CII groups at rest and during coughing (p < 0.05). The number of PCAs was significantly lower in the PIBI group compared with the CTPI and CII groups (p < 0.05). The QoR-15 score noticeably increased in the PIBI group compared with the CTPI and CII groups (p = 0.001 and p = 0.000, respectively).ConclusionsPIBI outperformed CTPI and CII in inducing analgesia for postoperative pain in patients undergoing VATS.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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