Liposomal Bupivacaine versus Bupivacaine with Dexamethasone for Rhomboid Intercostal and Sub-Serratus Block in Thoracoscopic Lobectomy: A Randomized Controlled Trial.
Liposomal bupivacaine prolonged analgesia duration versus bupivacaine-dexamethasone after thoracoscopic lobectomy
Liposomal Bupivacaine versus Bupivacaine with Dexamethasone for Rhomboid Intercostal and Sub-Serratus Block in Thoracoscopic Lobectomy: A Randomized Controlled Trial.
Liposomal bupivacaine may prolong analgesia in regional anesthesia; however, its effectiveness in fascial plane blocks remains uncertain.
This study compared liposomal bupivacaine plus bupivacaine with bupivacaine plus dexamethasone for rhomboid intercostal and sub-serratus (rhomboid intercostal and sub-serratus) plane block for postoperative analgesia following thoracoscopic lobectomy.
In this randomized, double-blind, parallel-group trial, 78 patients undergoing thoracoscopic lobectomy were randomly assigned (1:1) to receive either liposomal bupivacaine plus bupivacaine (LB group, n = 39) or bupivacaine plus dexamethasone (BD group, n = 39) for rhomboid intercostal and sub-serratus block.
liposomal bupivacaine gave nearly an hour longer analgesia than bupivacaine-dexamethasone, but benefit was limited
The AUC of resting Numeric Rating Scale pain scores over 72 h postoperatively was comparable between the LB and BD groups (110.8 ± 15.6 vs 113.4 ± 19.9 score·h; MD = 2.551, 95% CI -14.57 ~ 19.68, P = 0.767).
Similarly, no significant between-group differences were observed in the AUC of coughing pain scores (176.1 ± 17.4 vs 180.9 ± 18.4 score·h; MD = 4.795, 95% CI -12.04 ~ 21.63, P = 0.572).
However, cumulative oxycodone consumption and postoperative pain scores at all assessment time points were comparable between groups.
Compared with bupivacaine plus dexamethasone, liposomal bupivacaine for rhomboid intercostal and sub-serratus block in thoracoscopic lobectomy did not improve postoperative analgesia or reduce oxycodone consumption.
Moreover, although liposomal bupivacaine prolonged the duration of analgesia, the clinical benefit was limited.