What this Trial Is About

Researchers are evaluating different methods to manage pain after esophageal surgery, focusing on comparing a paravertebral block using liposomal bupivacaine with an epidural block using standard bupivacaine. The goal is to assess the overall benefit of analgesia after the surgery, considering that traditional epidural analgesia, while effective, has some potential drawbacks like low blood pressure and rare neurological issues. Liposomal bupivacaine, a long-acting local anesthetic, may provide longer pain relief and reduce the need for opioids. This trial includes 132 patients undergoing thoracoscopic esophagectomy with specific anesthesia procedures. One group receives a thoracic paravertebral block guided by ultrasound with injections of liposomal bupivacaine at several spinal levels. The other group receives an epidural block with standard bupivacaine. Postoperative pain is managed with patient-controlled analgesia using sufentanil in both groups, with doses adjusted based on patient size and pain levels. Rescue pain medications like acetaminophen, NSAIDs, or tramadol are available if needed. Participants will have their pain scores and overall analgesic benefit measured three days after surgery. Pain control will be monitored through patient reports, including use of rescue medications and pain assessments. The study runs from November 2024 to December 2027 and includes careful follow-up to evaluate the effectiveness and safety of these pain management approaches after esophageal surgery.

Postoperative Analgesia Between Paravertebral Block and Epidural Block in Esophageal Surgery