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已发表论文
脂质体布比卡因在超声引导下胸椎旁阻滞中减少胸外科手术后阿片类药物用量并加速恢复：一项随机对照试验
Authors Wang LL, Zhu Y , Hui LY, Zhang X, He JS, Zhang NL, Dong Y, Feng W
Received 30 June 2025
Accepted for publication 1 October 2025
Published 7 October 2025 Volume 2025:19 Pages 9137—9149
DOI https://doi.org/10.2147/DDDT.S550595
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Li-Lei Wang,1,2,* Youzhuang Zhu,1,* Li-Yuan Hui,2 Xiao Zhang,1 Jian-Shuai He,1 Nian-Liang Zhang,2 Yuan Dong,3 Wei Feng1
1Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China; 2Department of Anesthesiology, People’s Hospital of Rizhao, Rizhao, Shandong Province, People’s Republic of China; 3Neuropsychiatry Research Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, Shandong Province, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yuan Dong, Neuropsychiatry Research Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, Shandong Province, People’s Republic of China, Email dongyuan@qdu.edu.cn Wei Feng, Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China, Tel +860532-82919392, Email fengweisdqd@qdu.edu.cn
Background: Liposomal bupivacaine (LB) can provide prolonged analgesia, which may reduce patients’ opioid consumption, improve comfort, and facilitate recovery. Looser tissue and lower vascularity in the paravertebral space may facilitate LB diffusion and duration, so we investigated the effects of LB in multimodal analgesia after thoracic surgery with paravertebral block.
Methods: In this single-center, double-blind, randomized, parallel-controlled trial, 102 patients undergoing elective thoracoscopic surgery were randomized 1:1 to thoracic paravertebral block with LB (6.67 mg/mL) or ropivacaine hydrochloride (RH; 0.33%). The primary outcome was opioid consumption within 72 h postoperatively. Secondary outcomes included pain ratings at 6, 12, 24, 48, and 72 h postoperatively; rescue analgesia; time to first ambulation and defecation; post-anesthesia care unit and hospital length of stay; and adverse events.
Results: One patient was excluded due to block failure, leaving 101 patients (LB group, n = 51; RH group, n = 50). LB significantly reduced 72-h opioid consumption compared to RH (difference = – 181.4 mg; 95% CI: – 232.8, – 130.0 mg; P < 0.001), and fewer patients in the LB group required rescue analgesia compared to the RH group (OR: 0.33; 95% CI: 0.13, 0.82; P < 0.05). Pain scores at 24 h were lower in the LB group than RH group (difference = – 0.44; 95% CI: – 0.84, – 0.04; P < 0.05), with no differences at other timepoints. The LB group had shorter time to first ambulation than the RH group [median time (IQR): 20 (18– 24) h vs 26 (22– 32) h; HR: 3.81; 95% CI: 2.32, 6.19; P < 0.001] and shorter time to defecation [median time (IQR): 56 (42– 65) h vs 72 (57– 80) h; HR: 3.98; 95% CI: 2.46, 6.44; P < 0.001].
Conclusion: Ultrasound-guided paravertebral block with LB may reduce postoperative opioid consumption and enhance recovery in patients undergoing thoracic surgery.
Trial Registration: Chinese Clinical Trials Registry Platform (chictr.org.cn): ChiCTR2400091217.
Keywords: liposomal bupivacaine, multimodal analgesia, pain management, thoracic paravertebral block, video-assisted thoracoscopic surgery
1Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China; 2Department of Anesthesiology, People’s Hospital of Rizhao, Rizhao, Shandong Province, People’s Republic of China; 3Neuropsychiatry Research Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, Shandong Province, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yuan Dong, Neuropsychiatry Research Institute, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, Shandong Province, People’s Republic of China, Email dongyuan@qdu.edu.cn Wei Feng, Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China, Tel +860532-82919392, Email fengweisdqd@qdu.edu.cn
Background: Liposomal bupivacaine (LB) can provide prolonged analgesia, which may reduce patients’ opioid consumption, improve comfort, and facilitate recovery. Looser tissue and lower vascularity in the paravertebral space may facilitate LB diffusion and duration, so we investigated the effects of LB in multimodal analgesia after thoracic surgery with paravertebral block.
Methods: In this single-center, double-blind, randomized, parallel-controlled trial, 102 patients undergoing elective thoracoscopic surgery were randomized 1:1 to thoracic paravertebral block with LB (6.67 mg/mL) or ropivacaine hydrochloride (RH; 0.33%). The primary outcome was opioid consumption within 72 h postoperatively. Secondary outcomes included pain ratings at 6, 12, 24, 48, and 72 h postoperatively; rescue analgesia; time to first ambulation and defecation; post-anesthesia care unit and hospital length of stay; and adverse events.
Results: One patient was excluded due to block failure, leaving 101 patients (LB group, n = 51; RH group, n = 50). LB significantly reduced 72-h opioid consumption compared to RH (difference = – 181.4 mg; 95% CI: – 232.8, – 130.0 mg; P < 0.001), and fewer patients in the LB group required rescue analgesia compared to the RH group (OR: 0.33; 95% CI: 0.13, 0.82; P < 0.05). Pain scores at 24 h were lower in the LB group than RH group (difference = – 0.44; 95% CI: – 0.84, – 0.04; P < 0.05), with no differences at other timepoints. The LB group had shorter time to first ambulation than the RH group [median time (IQR): 20 (18– 24) h vs 26 (22– 32) h; HR: 3.81; 95% CI: 2.32, 6.19; P < 0.001] and shorter time to defecation [median time (IQR): 56 (42– 65) h vs 72 (57– 80) h; HR: 3.98; 95% CI: 2.46, 6.44; P < 0.001].
Conclusion: Ultrasound-guided paravertebral block with LB may reduce postoperative opioid consumption and enhance recovery in patients undergoing thoracic surgery.
Trial Registration: Chinese Clinical Trials Registry Platform (chictr.org.cn): ChiCTR2400091217.
Keywords: liposomal bupivacaine, multimodal analgesia, pain management, thoracic paravertebral block, video-assisted thoracoscopic surgery