Evaluating Liposomal Bupivacaine with Rhomboid Intercostal Block for Pain Relief After Video-Assisted Thoracoscopic Surgery in Adults Aged 18 to 64

What this Trial Is About

Researchers are investigating the use of liposomal bupivacaine combined with conventional bupivacaine in a rhomboid intercostal block RIB to manage postoperative pain in patients undergoing video-assisted thoracoscopic surgery VATS. VATS, a less invasive alternative to traditional thoracotomy, often leads to acute pain in over 80% of patients, which can cause complications and affect recovery. This study aims to evaluate and compare the effectiveness and safety of this novel anesthesia technique in a randomized controlled trial sponsored by Beijing Tiantan Hospital. Participants will receive either an ultrasound-guided rhomboid intercostal block with standard bupivacaine or a combination of liposomal bupivacaine plus bupivacaine before surgery. The block is performed via Doppler ultrasound with a 22-gauge needle at the T5-T6 level near the scapula, injecting 20 mL of the assigned anesthetic solution into the rhomboid-intercostal fascial plane. Postoperatively, all patients will have access to patient-controlled analgesia PCA with sufentanil and ondansetron, with additional oral oxycodone-acetaminophen or intravenous morphine if needed for pain relief. During the study, patients will be monitored for various outcomes including opioid use within 48 hours after surgery, pain scores at rest and during movement up to 3 months postoperatively, time to first analgesia request, sedation levels, recovery quality, length of hospital stay, and adverse events. Assessments occur frequently during the first 72 hours and at 1 week, 1 month, and 3 months after surgery. This comprehensive follow-up aims to measure both immediate and longer-term pain management and recovery, with study participation lasting up to three months post-surgery.

The Efficacy and Safety of Liposomal Bupivacaine for Rhomboid Intercostal Nerve Block in Relieving Postoperative Pain After Video-assisted Thoracoscopic Surgery