Programmed intermittent paravertebral bolus infusion reduces the incidence of postoperative chronic pain three months after thoracoscopic surgery in elderly patients: an observational study

The aim of this study was to examine the association between programmed intermittent paravertebral bolus infusion and chronic post-surgical pain (CPSP), including pain components and pain distribution, following video-assisted thoracoscopic surgery (VATS) in elderly patients. An Observational Study. This study was conducted at Beijing Chest Hospital, Capital Medical University. Elderly patients undergoing VATS. Patients in the paravertebral group received programmed intermittent paravertebral bolus infusion with local anesthetics postoperatively, while patients in the intravenous group received patient controlled intravenous analgesia (PCIA) with sufentanil. CPSP in our study was defined according to the International Classification of Diseases (ICD-11). Among the 242 elderly patients, Group P had a lower incidence of persistent pain at 3 months postoperatively compared to Group I (3.5% versus 13.4%, p = 0.014). Group P also had a lower incidence of anterior chest pain than Group I at both 1 month (p = 0.005) and 3 months (p = 0.020) postoperatively. Additionally, at 3 months, Group P had a lower incidence of neuropathic pain than the Group I (p = 0.021). Furthermore, Group P demonstrated reduced rates of pricking pain and hyperesthesia compared to Group I (p = 0.024; p = 0.042). Programmed intermittent paravertebral bolus infusion reduces the incidence of postoperative chronic pain in patients undergoing thoracic surgery. It also decreases the occurrence of neuropathic pain three months after surgery.