The Effect of Thoracic Paravertebral Block on Postoperative Pain After Coronary Artery Bypass Graft Surgery: A Retrospective Study.

Objectives: To evaluate the effect of bilateral single-shot thoracic paravertebral block (PVB) on postoperative analgesia in patients undergoing coronary artery bypass grafting (CABG) surgery.

Design: A retrospective cohort study.

Setting: A single tertiary university hospital.

Participants: Patients who underwent elective CABG surgery.

Interventions: Among 110 patients included in the study, 59 received general anesthesia alone (Group C: control group), while 51 received general anesthesia combined with a bilateral single-dose thoracic PVB (Group B: block group).

Measurements and main results: Demographic characteristics, intraoperative fentanyl consumption, postoperative paracetamol requirements, and pain scores-documented in patient records using the visual analog scale at 2, 4, 16, and 24 hours-along with extubation time, intensive care unit and hospital length of stay, time to first mobilization, and time to chest drain removal were retrospectively collected and analyzed. Group B showed significantly lower intraoperative fentanyl and postoperative paracetamol use compared with Group C (p < 0.05). Visual analog scale scores were significantly lower in Group B (p < 0.05). Additionally, extubation time, intensive care unit length of stay, and time to mobilization were significantly shorter in Group B (p < 0.05). No significant differences were observed in total hospital length of stay or chest drain removal time (p > 0.05).

Conclusions: Bilateral single-shot thoracic PVB may be a safe and effective adjunct to general anesthesia in patients undergoing CABG surgery. In this retrospective study, PVB was associated with superior analgesia, decreased opioid consumption, and improved early recovery parameters. These findings support the integration of PVB into multimodal analgesia protocols; however, prospective randomized controlled trials are needed to validate these results.