A meta-analysis of 35 randomized trials compared two methods of pain relief after thoracic surgery: paravertebral block (PVB) and thoracic epidural analgesia (TEA).[1] Thoracic epidural analgesia provided better pain control 24 hours after surgery—pain scores were 0.41 points lower at rest and 0.40 points lower with movement.[1] After 48 hours, however, there were no significant differences in efficacy between the two methods.[1] Paravertebral block was associated with a significantly lower risk of adverse events: hypotension (87% lower risk), postoperative nausea and vomiting (62% lower risk), and urinary retention (77% lower risk).[1] The incidence of pulmonary complications was comparable between the two groups.[1] The study concluded that paravertebral block is a safer and equally effective alternative to thoracic epidural analgesia in thoracic surgery.[1]