Frontiers in medicine · 2026
Efficacy of different nerve block techniques with liposomal bupivacaine for postoperative analgesia in patients undergoing single-port video-assisted thoracoscopic partial lung resection.
Клиническое исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Zhang Ying, Liang Dongke, Liu Guofeng, Huang Yangsi, Zhong Haiping, Yang Nuo, Zhong Yu, Chen Yanhua
Аннотация
OBJECTIVE: To compare postoperative analgesia efficacy between liposomal bupivacaine-administered thoracic paravertebral blockade (TPVB) and thoracoscopic direct intercostal nerve blockade (INB) in uniportal video-assisted thoracoscopic surgery (VATS) for partial lung resection.
METHODS: A randomized controlled design enrolled 60 elective surgery patients, randomized in a 1:1 ratio to TPVB or INB groups. TPVB received 133 mg liposomal bupivacaine (20 mL) via ultrasound-guided T4 injection; INB got the same dose via thoracoscopic-guided 3rd-7th intercostal injection. Primary endpoint: 72-h postoperative VAS scores at rest/coughing. Secondary outcomes: sufentanil use, PCIA presses, rescue analgesics, complications, and 1-6 month chest pain NRS scores.
RESULTS: Baseline demographic and clinical characteristics were comparable between the two groups. No significant differences in VAS scores at 6 h, 24 h, 48 h, or 72 h (all p > 0.05). There were no statistically significant differences between the two groups in intraoperative and postoperative opioid consumption, the need for rescue analgesia, postoperative recovery indicators (time to first ambulation, chest tube removal time, and length of hospital stay), or the incidence of adverse reactions. Additionally, there were no significant differences in NRS scores for chest-related chronic pain between the two groups at 1, 3, and 6 months postoperatively (p > 0.05).
CONCLUSION: For uniportal VATS, liposomal bupivacaine administered via TPVB or INB showed no statistically significant differences at the primary 6-h assessment or subsequent time points in early analgesia, safety, or long-term chronic pain impact. Pain scores were low in both groups throughout the 72-h period. However, the results do not establish equivalence between the two approaches, and as this trial compared two active interventions without a placebo arm, the absolute analgesic efficacy of each technique cannot be independently determined.
CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=206795, ChiCTR2300075637.
METHODS: A randomized controlled design enrolled 60 elective surgery patients, randomized in a 1:1 ratio to TPVB or INB groups. TPVB received 133 mg liposomal bupivacaine (20 mL) via ultrasound-guided T4 injection; INB got the same dose via thoracoscopic-guided 3rd-7th intercostal injection. Primary endpoint: 72-h postoperative VAS scores at rest/coughing. Secondary outcomes: sufentanil use, PCIA presses, rescue analgesics, complications, and 1-6 month chest pain NRS scores.
RESULTS: Baseline demographic and clinical characteristics were comparable between the two groups. No significant differences in VAS scores at 6 h, 24 h, 48 h, or 72 h (all p > 0.05). There were no statistically significant differences between the two groups in intraoperative and postoperative opioid consumption, the need for rescue analgesia, postoperative recovery indicators (time to first ambulation, chest tube removal time, and length of hospital stay), or the incidence of adverse reactions. Additionally, there were no significant differences in NRS scores for chest-related chronic pain between the two groups at 1, 3, and 6 months postoperatively (p > 0.05).
CONCLUSION: For uniportal VATS, liposomal bupivacaine administered via TPVB or INB showed no statistically significant differences at the primary 6-h assessment or subsequent time points in early analgesia, safety, or long-term chronic pain impact. Pain scores were low in both groups throughout the 72-h period. However, the results do not establish equivalence between the two approaches, and as this trial compared two active interventions without a placebo arm, the absolute analgesic efficacy of each technique cannot be independently determined.
CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=206795, ChiCTR2300075637.