Study of Use of Paravertebral Blocks for Pain Relief in Video Assisted Lung Surgery

This project involves looking at the timing of providing pain relief for patients who are having lung surgery via the use of a small camera inserted into the chest with a scope (Video assisted thorascopy). This procedure can be the source of intense pain both immediately after the procedure and in the longer term leading to chronic pain problems. Local anaesthetic placed in the paravertebral space which is located adjacent to the spinal column, where the pain nerve fibres are located, is a well recognized method of providing pain relief for these procedures. It is currently unclear as to the best timings for providing this type of pain relief with some centres placing the local anaesthetic at the start of the procedure and some at the end. Placing a high volume of local anaesthetic into this area at the start of the case may provide better short and long term pain relief than placing it at the end of the procedure. The investigators hope to show a difference between the two timings to allow for better pain relief for these procedures. This would be a feasibility study that would lead onto a multicentre trial to eventually create a best practice protocol for pain relief for lung resection via this surgical method.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Subjects will be recruited from patients admitted for elective VATS for lung resection.
* Patients aged 18 and over.
* Patient's will be ASA 1,2 or 3.

Exclusion Criteria:

* Patient refusal.
* Emergency surgery.
* Patient unable to provide consent.
* Infection in paravertebral space.
* Patients who attend a chronic pain clinic on high doses of opiate drugs.
* History of Anaphylaxis/allergy to local anaesthetic.