·From May 2020 to October 2020, 121 consecutive general anaesthesia patients scheduled for video-assisted thoracoscopic segmentectomy or lobectomy in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were allocated to thoracic paravertebral block (TPVB) group (group T, n=60) or multiple spinal nerve block group (group M, n=61). Group T received ultrasound-guided TPVB on the T₅ level with 40 mL 0.3% ropivacaine. Group M received ultrasound-guided multiple spinal nerve block including serratus anterior plane block on the 5th intercostal space with 10 mL 0.3% ropivacaine, erector spinae plane block on the T₅ level with 10 mL 0.3% ropivacaine, retrolaminar block on the T₅ level with 10 mL 0.3% ropivacaine, and retrolaminar block on the T₃ level with 10 mL 0.3% ropivacaine. Perioperative hemodynamic characters, postoperative Numeric Rating Scale (NRS) scores of incision pain and visceral pain, and major adverse events were compared between the two groups.

·There was no significant difference in clinical characteristics, perioperative hemodynamic characters, and the use and dose of intraoperative analgesics or vasoactive drugs between the two groups (P>0.05). The NRS scores of incision pain and visceral pain in group M were lower than those in group T during postoperative 24 h (Calm: incision pain, P=0.001; visceral pain, P=0.000. Coughing: incision pain, P=0.000; visceral pain, P=0.000). NRS scores of visceral during pain postoperative 48 h in group M were significantly lower than those of group T (P=0.006) when coughing. Compared with group T, the pressing times of patient-controlled intravenous analgesia pump and the usage of flurbiprofen decreased in group M within 48 h after operation (both P=0.000), and the time of first postoperative pain was delayed (P=0.002). The postoperative activity time was advanced (P=0.000), and the incidence of vomiting decreased within 48 h after operation (P=0.025).

·Multiple spinal nerve block has better analgesic effect on video-assisted thoracoscopic segmentectomy or lobectomy than TPVB, which relieves both incision pain and visceral pain. There is no difference in clinical safety between the multiple spinal nerve block and TPVB.