Impact of liposomal bupivacaine parasternal block combined with rectus sheath block on postoperative pain in patients undergoing sternotomy for cardiac surgery: a randomized controlled trial.
Liposomal bupivacaine block cuts opioid use after cardiac sternotomy versus ropivacaine
Impact of liposomal bupivacaine parasternal block combined with rectus sheath block on postoperative pain in patients undergoing sternotomy for cardiac surgery: a randomized controlled trial.
To compare the effects of liposomal bupivacaine and ropivacaine for ultrasound-guided parasternal block combined with rectus sheath block (PSB + RSB) on acute and chronic postoperative pain in patients undergoing cardiac sternotomy, so as to provide an evidence-based basis for optimizing the multimodal analgesia regimen for such surgeries.
A total of 90 patients scheduled for elective median sternotomy cardiac and great vessel surgery at the Institute of Cardiovascular Diseases, The First Affiliated Hospital of Guangxi Medical University from April 2024 to February 2025 were enrolled.
At 4 h and 12 h post-extubation, the activity-related NRS scores in group LB were significantly lower than those in group ROP [ 2.00(2.00, 2.00) points vs 2.00(2.00,3.00) points, 2.00(2.00,3.00) points vs 3.00(2.00,4.00) points, all P < 0.05].
At 24 h, 48 h and 72 h post-extubation, the QoR-15 scores in group LB were significantly higher than those in group ROP [(85.4±11.78) points vs (74.7±9.89) points, (91.6±10.4) points vs (86.8±8.6) points, (107.1±9.87) points vs (100.0±9.15) points, all P < 0.05].
The use of liposomal bupivacaine for PSB+RSB block in patients undergoing cardiac sternotomy can significantly reduce postoperative analgesic consumption, optimize early analgesic effect, and improve postoperative recovery quality.
However, attention should be paid to the risk of nausea and vomiting, and individualized selection should be made after balancing the benefits and risks in clinical application.