Paravertebral Block With Liposomal Bupivacaine and Epidural Block With Plane Bupivacaine for Postoperative Analgesia in Esophageal Surgery: A Randomized, Non-inferiority Study

What this Trial Is About

Researchers are evaluating two methods for managing postoperative pain in patients undergoing thoracoscopic esophagectomy: thoracic paravertebral block (TPVB) with liposomal bupivacaine and epidural block with standard bupivacaine. The study aims to compare the overall benefit of analgesic score (OBAS) three days after surgery. This trial addresses the need for effective pain control while considering potential drawbacks of epidural analgesia, such as hypotension and rare neurological complications. Patients will be randomly assigned to one of two groups. The experimental group receives ultrasound-guided TPVB injections of liposomal bupivacaine at multiple thoracic paravertebral spaces, followed by patient-controlled intravenous analgesia (PCIA) using sufentanil. The control group is treated with an epidural block at T6-T8 and patient-controlled epidural analgesia (PCEA) with sufentanil and bupivacaine hydrochloride. Rescue analgesics include acetaminophen or NSAIDs for mild pain and tramadol for more severe pain, with doses adjusted by the acute pain service team. Participants will be closely monitored for pain scores using visual analog scales, opioid consumption, mean arterial pressure, and hospital stay duration. Pain relief assessments and questionnaires are completed during the first three postoperative days. The study is triple-blinded and involves continuous evaluation of safety and analgesic benefit. Total in-hospital monitoring averages about ten days, with follow-up on analgesic outcomes and recovery progress.

Postoperative Analgesia Between Paravertebral Block and Epidural Block in Esophageal Surgery