Costotransverse Foramen Block vs Thoracic Paravertebral Block in Thoracotomy Pain Management

Thoracotomy, a type of surgery for lung cancer, is known to be one of the most painful procedures. Around 75% of patients experience moderate to severe pain after the surgery. To manage this pain, doctors use various techniques such as thoracic epidural analgesia (TEA), thoracic paravertebral block (TPVB), and erector spinae plane block (ESPB). TEA, once considered the best method, has side effects that prompted researchers to explore other options. One such alternative is the costotransverse foramen block (CTFB), a recently introduced technique that has shown promise in both cadaveric and case studies. This study aims to find a safer and more effective method to manage post-thoracotomy pain. During the study, participants will receive either a CTFB or a TPVB. If a patient's pain level, measured on a visual analog scale (VAS), reaches 4 or higher, they will be given a 4 mg bolus of morphine as a rescue analgesic. The study's primary outcome is to measure the total amount of morphine consumed by each patient. This will help determine which technique, CTFB or TPVB, is more effective in managing pain after thoracotomy.