Regional Vs Intercostal Blocks for Minimally Invasive Thoracic Surgery

Pain control after thoracic surgery remains a challenge. There is little consensus as to how to manage an individual patient undergoing minimally invasive approaches. For most thoracic operations we recommend that technique performance, anesthesiologist and surgeon skill sets, failure rates, and the possibility of side effects or complications should be taken into consideration when choosing the optimal regional nerve block technique for a patient. Thoracic epidural analgesia is the gold standard for thoracotomy procedures. For minimally invasive approaches either an erector spinae block catheter or paravertebral block catheter is the optimal first line regional anesthesia technique.