Ultrasound-Guided Thoracic Paravertebral Block for Uniportal VATS Sublobar Resection: A Case Report

Background: Lung cancer remains one of the leading causes of cancer-related mortality worldwide. Despite the numerous advantages of video-assisted thoracoscopic surgery (VATS) in thoracic surgery, postoperative pain continues to pose a significant challenge, contributing to pulmonary complications and delayed recovery. Given the limited efficacy and notable adverse effects of systemic opioids, opioid-sparing multimodal analgesic strategies—including regional nerve block techniques such as the paravertebral block—have gained increasing attention for optimizing postoperative pain management and enhancing recovery. Objective: This case report aims to illustrate the clinical application and analgesic efficacy of an ultrasound-guided single-injection TPVB, combined with a preoperative nonsteroidal anti-inflammatory drug (NSAID), as a component of an opioid-sparing multimodal regimen in a patient undergoing VATS sublobar resection. Methods: A 36-year-old female underwent VATS sublobar resection of a right upper lobe nodule. To achieve opioid-sparing multimodal analgesia, the anesthesiologist implemented a regimen consisting of an intravenous NSAID (flurbiprofen axetil 50 mg) administered 30 minutes before the end of surgery, followed by an ultrasound-guided thoracic paravertebral block (TPVB) with 25 mL of 0.25% ropivacaine injected as a single shot postoperatively. Conclusions: A single-injection thoracic paravertebral block (TPVB) represents a highly effective component of a multimodal analgesic strategy, offering profound and opioid-sparing analgesia for thoracic surgical procedures.