Cardiothoracic & vascular anaesthesia
Comparison of intrathecal morphine versus thoracic paravertebral block for video-assisted thoracoscopic surgery: a randomized non-inferiority trial
Authors' conclusion
ITM did not demonstrate non-inferiority to TPVB for 24-hour IV-MME; TPVB was associated with lower systemic opioid use, while pain outcomes were similar.
Study context
- Population
- Adults undergoing elective video-assisted thoracoscopic surgery (VATS)randomized
- Participants
- 72 adults
- Comparison
- Intrathecal morphine (ITM) vs thoracic paravertebral block (TPVB)
- ITMn = 36
- TPVBn = 36reference
- Primary endpoint
- 24-hour IV-MME (intraoperative opioids excluded)
- Follow-up
- 24 hours
Methodological detailsprospective, observer-blinded, non-inferiority
- Prospective
- Observer-blinded
- Non-inferiority
Primary result
As reported in the abstract
24-hour IV-MME
ITM vs TPVBMedian difference, mg (95% CI)P value
ITT
6.5(1–17)
P = 0.009Per-protocol
9.0(2–18)
P = 0.002Non-inferiority margin 5.05 as printed, not drawn
Secondary outcomes
| Outcome | ITM | TPVB | P value |
|---|---|---|---|
| Rescue analgesia | 21/36 | 12/36 | P = 0.033 |
Individual 24-hour and 12-hour intravenous morphine milligram equivalents (IV-MME)
- Favored TPVB
Pain, quality of recovery scores, time to first opioid demand
- Similar between groups
Safety
Respiratory depression
- No respiratory depression
30-day Clavien-Dindo grade I events
- Mild events differed between groups; no apparent clinically meaningful safety signal
Original publication
Comparison of intrathecal morphine versus thoracic paravertebral block for video-assisted thoracoscopic surgery: a randomized non-inferiority trial. Reg Anesth Pain Med. Published 17 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →