There is a common belief among thoracic anesthesiologists that post-thoracoscopy procedures produce less pain intensity versus thoracotomy, which is partially true. Although thoracoscopic surgery reduces postoperative pain compared with open thoracotomy, patients can also experience moderate to severe pain, especially during the first few hours after thoracoscopic surgery.[1] However, effective management of acute pain following either thoracotomy or thoracoscopy is needed to prevent postoperative complications and reduce the likelihood of developing chronic pain. Earlier on in our center we have conducted a randomized controlled trial on pain relief following thoracoscopic sympathectomy for palmar hyperhidrosis and we concluded that instillation of local anesthetic in the pleural space provided optimal analgesic conditions postoperatively.[2] Extrapleural block and thoracic paravertebral block are …

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Abdullah Aldohayan 1, Abdelazeem Eldawlatly 2