Abstract
<title>Abstract</title> <p> <bold>OBJECTIVES</bold> Paravertebral blockade is versatile and can be applied unilaterally or bilaterally. While the feasibility and efficacy of bilateral sequential thoracic paravertebral block (TPVB) on pain after simultaneous bilateral uniportal video-assisted thoracoscopic surgery (UVATS) have not been established. Therefore, we conducted this randomized double-blinding trial to test the hypothesis that bilateral sequential TPVB, performed preoperatively, reduced pain scores after simultaneous bilateral UVATS. <bold>METHODS</bold> 80 patients, who were scheduled to underwent bilateral UVATS, were randomly assigned to two groups: the control group received patient-controlled intravenous analgesia (PCIA) alone. The bilateral TPVB group received PCIA plus single-injection TPVB with 0.375% ropivacaine under ultrasound guidance on each side. Postoperative pain was assessed in both groups at 6, 12, 24 and 48h by using the numeric rating scale (NRS) score. Perioperative opioid consumption, postoperative nausea and vomiting (PONV) and the presence of chronic pain on postoperative day (POD) 90 were recorded. <bold>RESULTS</bold> The primary outcome was the NRS score during coughing at 24 hours postoperatively. Compared to the control group, the pain scores, assessed at 6, 12 and 24 h after surgery, were reduced in the bilateral TPVB group. The postoperative sufentanil use was lower in the bilateral TPVB group in the POD1. There was no significant difference between two groups in the incidence of PONV and chronic pain. <bold>CONCLUSIONS</bold> Bilateral sequential TPVB improves postoperative pain management for patients undergoing simultaneous bilateral UVATS. <bold>Registry</bold> : Chinese Clinical Trial, identifier: ChiCTR2200065541, Registration date: 8 November 8 2022 </p>