{
  "abstract": "Background and Aims Video-assisted thoracoscopic surgery may be considered less invasive than an open thoracotomy, however it is also related with significant postoperative pain. Analgesia requirements after thoracic surgery are expected to be high and pain if remains untreated has been related with high incidence of chronic neuropathic pain. Therefore, a solid postoperative analgesic strategy should be implemented. Different regional analgesia techniques have gained popularity as we move away from thoracic epidural which used to be the gold standard for many decades for thoracic surgery. Intercostal blocks are a popular and well established and can be performed as one shot injection by anaesthesiologists. Nevertheless , they can also be performed by the surgical team under direct vision.Methods Our postoperative protocol for pain management after thoracic surgery includes polytropic analgesia with remifentanil TCI intraoperatively and also titrated doses of intravenous morphine 10 mg , paracetamol 1 gr, parecoxib 40 mg, clonidine 50–150 mcg, magnesium sulfate 25%. At the end of the procedure a single shot injection of 20 ml of ropivacaine 0,375% is given into the paravertebral space for postoperative analgesia. In addition paracetamol and parecoxib are prescribed regularly every 6 hours and every 12 hours respectively. Tramadol 100 mg can be given if needed as rescue dose for pain > 5 based on VAS score evaluation.Results Based on our data, the vast majority of patients reports low pain with minimum requirements for extra analgesia for the first 24 hours. Patient satisfaction scores also achieve high levels. Postoperative complications, involving nausea and vomiting, pruritus and hypotension, are also extremely low.Conclusions Paravertebral blocks with Ropivacaine 0,375% performed by surgeons facilitate time efficiency and provide adequate postoperative analgesia for thoracoscopic video-assisted thoracic surgery.",
  "authors": [
    {
      "affiliations": [
        "Anesthesia Chronic Pain, Aristotle University of Thessaloniki, Thessaloniki, Greece"
      ],
      "name": "Despoina Sarridou"
    },
    {
      "affiliations": [
        "Anesthesia Chronic Pain, Aristotle University of Thessaloniki, Thessaloniki, Greece"
      ],
      "name": "Eleni Moka"
    },
    {
      "affiliations": [
        "Anesthesia Chronic Pain, Aristotle University of Thessaloniki, Thessaloniki, Greece"
      ],
      "name": "Konstantina Malliou"
    },
    {
      "affiliations": [
        "Anesthesia Chronic Pain, Aristotle University of Thessaloniki, Thessaloniki, Greece"
      ],
      "name": "Marianna Feggoudaki"
    },
    {
      "affiliations": [
        "Anesthesia Critical Care, AHEPA University Hospital, Thessaloniki, Greece"
      ],
      "name": "Magdalena Kiparissa"
    },
    {
      "affiliations": [
        "Anesthesia Critical Care, Aristotle University of Thessaloniki, Thessaloniki, Greece"
      ],
      "name": "Vasileios Grosomanidis"
    },
    {
      "affiliations": [
        "Anesthesia Critical Care, Aristotle University of Thessaloniki, Thessaloniki, Greece"
      ],
      "name": "Helena Argiriadou"
    },
    {
      "affiliations": [
        "Anesthesia Chronic Pain, Aristotle University of Thessaloniki, Thessaloniki, Greece"
      ],
      "name": "Aikaterini Amaniti"
    }
  ],
  "title": "P216 Paravertebral blocks performed by surgeons for postoperative analgesia after video-assisted thoracoscopic surgery. Friend or foe? A presentation of a local protocol",
  "uid": "f9d685ee-f9d5-52a0-bbe9-d21ea43ff849"
}