The purpose of this study is to find out which pain relief method works better for people having video-assisted thoracoscopic surgery. We will compare two techniques: thoracic paravertebral block (TPVB), a numbing injection near the spine, and intrathecal morphine (ITM), a small dose of morphine injected into the spinal fluid. We want to see if ITM works as well as TPVB in reducing the need for pain medicine during the first 24 hours after surgery. People in the study will get either TPVB or ITM before going to sleep for surgery, use a patient-controlled pain pump after surgery, and have their pain scores, medicine use, recovery, and possible side effects checked for up to 30 days after surgery.
Who can participate
Age range18 Years – 75 Years
SexALL
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Inclusion criteria
✓. Age between 18 and 75 years
✓. American Society of Anesthesiologists (ASA) physical status I-III
✓. Scheduled for elective video-assisted thoracoscopic surgery (VATS) for wedge resection, segmentectomy, or lobectomy
✓. Ability to understand the study protocol and provide written informed consent
Exclusion criteria
✕. Refusal to participate
✕. Pregnancy
✕. Morbid obesity (body mass index \> 30)
✕. Known allergy to opioids, local anesthetics, or NSAIDs
✕. History of neuropsychiatric disorder, cognitive impairment, or inability to communicate with investigators
✕. History of substance abuse
✕
What they're measuring
1
Cumulative IV Morphine Milligram Equivalents (IV-MME) in the First 24 Hours After Surgery