Paravertebral block versus thoracic epidural analgesia for video-assisted thoracic surgery

INTERVENTION: Patients were randomly allocated by a computer‐generated random number list to receive patient‐controlled PVB (PVB group) or thoracic epidural analgesia (TEA group) for postoperative analgesia before being transferred to the operating room. 1. In the PVB group, patients receive single intercostal video‐assisted thoracic surgery and patient‐controlled paravertebral block for postoperative analgesia. 2. In the TEA group, patients receive thoracic epidural analgesia for postoperative analgesia and single intercostal video‐assisted thoracic surgery In the case of analgesic failure, intramuscular dezocine 10 mg (Jiangsu, China) was used as rescue medication. The chest tube was removed when there was no air leakage and the volume of drainage was less than 100 mL/24 hours. The criteria for hospital discharge included chest tube removal, adequate oral intake, pain controlled by oral analgesics and assessment of patients’ well‐being by their attending doctors. CONDITION: Pain in the postoperative period ; Surgery PRIMARY OUTCOME: Pain measured using the visual analogue score (VAS) in the state of rest and coughing postoperatively at 1, 6, 24, 48, and 72 hours SECONDARY OUTCOME: ; 1. The number of patients who required rescue medication and the cumulative dezocine dose administered during postoperative days (PODs) 0‐3, recorded at 8:00 on PODs 1‐4; 2. Quality of life measured using the European Organization for Research and Treatment of Cancer (EORCT) general quality of life questionnaire (QLQ‐C30) within 1 days prior to surgery, 3 days after the operation; 3. Overall satisfaction with analgesic modality measured using a 5‐point scale (1=dissatisfied, 5=satisfied) on POD 3; 4. Complications after surgery, such as nausea and vomiting, hypertension, chylothorax and atrial fibrillation, recorded after surgery and before discharge; INCLUSION CRITERIA: Patients diagnosed with solitary pulmonary nodules and without chronic pain (with no pain medications routinely used) deemed suitable to undergo three‐port single‐intercostal VATS by surgeons