Dong Lingjun, Wang Xiang, Fu Linhai, Jiang Zongming, Wang Yulong, Chen Aixia, Ding Jianyi, Yu Guangmao
Department of Thoracic Surgery, Shaoxing People's Hospital, 568-Zhongxing North Road, Shaoxing 312000, Zhejiang, China.
Department of Anesthesiology, Shaoxing People's Hospital, 568-Zhongxing North Road, Shaoxing 312000, Zhejiang, China.
Pain Res Manag. 2025 Jul 9;2025:8816879. doi: 10.1155/prm/8816879. eCollection 2025.
Postoperative pain in thoracic surgery often requires opioids, yet can be poorly managed with short-acting anesthetics. Liposomal bupivacaine (LB) offers prolonged analgesia, potentially improving pain control and reducing opioid use. This study evaluates LB's effectiveness and safety in thoracic postoperative pain management, aiming to provide an alternative to current practices. In this single-center, double-blind, prospective, randomized controlled trial, patients undergoing uniportal lobectomy, segmentectomy, or wedge resection from November 2023 to May 2024 were enrolled. Participants were randomly assigned in a 1:1 ratio to receive either 0.375% ropivacaine (control group, = 57) or LB (LB group, = 56) for intercostal nerve blocks (ICNBs). Postoperative visual analog scale (VAS) scores, opioid consumption, overall benefit of analgesia score (OBAS), chest tube duration, length of hospital stay, and adverse events (AEs) were recorded and analyzed. Data from 57 patients in the control group and 56 patients in the LB group were included in the analysis, with no significant demographic differences between the groups. The LB group demonstrated lower VAS scores at rest and during activity ( > 0.05), reduced opioid consumption (=0.021), and higher OBAS ( < 0.01) compared with the control group. No significant differences were observed in chest tube duration, length of hospital stay, or AEs between the groups. LB is safe and effective for ICNB, providing significant postoperative pain relief for patients undergoing uniportal thoracoscopic surgery. Chinese Registry of Clinical Trials: chiCTR2300075463.
胸外科手术后的疼痛通常需要使用阿片类药物，但短效麻醉剂对其管理效果往往不佳。脂质体布比卡因（LB）可提供长效镇痛，有可能改善疼痛控制并减少阿片类药物的使用。本研究评估LB在胸科术后疼痛管理中的有效性和安全性，旨在为当前的治疗方法提供一种替代方案。在这项单中心、双盲、前瞻性、随机对照试验中，纳入了2023年11月至2024年5月接受单孔肺叶切除术、肺段切除术或楔形切除术的患者。参与者按1:1的比例随机分配，接受0.375%的罗哌卡因（对照组，n = 57）或LB（LB组，n = 56）进行肋间神经阻滞（ICNB）。记录并分析术后视觉模拟评分（VAS）、阿片类药物消耗量、镇痛总体效益评分（OBAS）、胸管留置时间、住院时间和不良事件（AE）。分析纳入了对照组的57例患者和LB组的56例患者的数据，两组间的人口统计学差异无统计学意义。与对照组相比，LB组在静息和活动时的VAS评分更低（P > 0.05），阿片类药物消耗量减少（P = 0.021），OBAS更高（P < 0.01）。两组在胸管留置时间、住院时间或AE方面未观察到显著差异。LB用于ICNB是安全有效的，可为接受单孔胸腔镜手术的患者提供显著的术后疼痛缓解。中国临床试验注册中心：chiCTR2300075463。
