Peri-Operative Pain Control for Single-Port VATS

Introduction

Video-Assisted Thoracoscopic Surgery (VATS) is known to cause significant postoperative pain which can negatively impact pulmonary function, increase the risk of pulmonary complications, and reduce patient satisfaction. Traditionally, multi-port VATS involves several incisions, often resulting in considerable generalized chest wall pain. At our institution, intercostal nerve blocks along with postoperative single-shot paravertebral blocks (PVBs) and a multimodal pain regimen have been routinely utilized. However, single-port VATS has become increasingly common due to its potential benefits. It has been hypothesized that single-port VATS may reduce generalized chest wall pain due to fewer incisions, but it can lead to more localized port site pain and referred diaphragmatic discomfort due to the single port location and size. Despite the single incision, postoperative pain remains a significant concern.