Effect of General Anesthesia Combined with Single-Shot, Single-Level Thoracic Paravertebral Block on Postoperative Analgesia in Children Undergoing Thoracoscopic Mediastinal Tumor Resection: A Randomized Controlled Trial.
Lan Sun, Zhengzheng Gao, Lijing Li et al.
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In 30 seconds
This single-centre prospective randomised controlled trial evaluated unilateral, ultrasound-guided, single-level thoracic paravertebral block (TPVB) in children aged 4–12 years undergoing thoracoscopic mediastinal tumor resection. Children received general anesthesia alone or general anesthesia with preincision TPVB. Over the first 24 hours, the area under the FLACC pain-score curve was lower with TPVB (41.3/240 vs 53.0/240; mean difference (T - G), -11.8; 95% confidence interval, -14.2 to -9.34, p < 0.001). TPVB was also associated with higher 24-hour QoR-15 scores and reductions in anesthetic use, rescue opioids, and hospital stay.
Key findings
- First-24-hour AUC-FLACC was 41.3/240 with TPVB versus 53.0/240 with general anesthesia alone; mean difference (T - G), -11.8; 95% confidence interval, -14.2 to -9.34, p < 0.001.
- Pain scores were lower with TPVB during the first 20 postoperative hours, and QoR-15 scores were higher at 24 hours.
- Intraoperative anesthetic use, postoperative rescue opioid consumption, and hospital stay were reduced with TPVB.
Why it matters
Effective early pain control is important after pediatric thoracoscopic surgery. In this trial, adding a single-shot, single-level TPVB was associated with lower postoperative pain and opioid use, alongside better short-term recovery scores. These findings provide comparative evidence for this regional analgesic approach in the specific setting of pediatric mediastinal tumor resection.
What to keep in mind
The trial was conducted at a single centre, and the reported recovery assessment was short term.