Thoracic Surgery Clinical Trial
Official title:
Effect of Ultrasound-guided Rhombic Intercostal Nerve Block With Liposomal Bupivacaine Versus Bupivacaine Hydrochloride Combined With Dexamethasone in Thoracoscopic Pneumonectomy on Postoperative Pain: a Non-inferiority Study
The purpose of this study, is to investigate the effectiveness of ultrasound-guided rhombic intercostal nerve block for postoperative pain control in thoracoscopic pulmonary resection with bupivacaine liposomes versus bupivacaine hydrochloride with dexamethasone to assess whether bupivacaine liposomes will produce analgesia superior to bupivacaine hydrochloride with dexamethasone in terms of analgesia effect and duration of analgesia. This study will also evaluate whether liposomal bupivacaine after nerve block improves the quality of postoperative recovery compared to bupivacaine hydrochloride combined with dexamethasone.
Approved by the Ethics Committee of Jiaxing No. 1 Hospital (approval number: 2024-KY-226). This study was enrolled prior to patient enrollment in the clinical trial. Written informed consent was obtained from all participants. The study is expected to be conducted from April 2024 through December 2025. This study enrolls 130 thoracoscopic pneumonectomy patients between the ages of 18-80 years, ASA Physical Status I and III, who underwent elective or limited partial pneumonectomy and had no allergic reaction to the study drug. Basic monitoring such as electrocardiogram, pulse oximetry, and noninvasive blood pressure were arranged preoperatively. The bupivacaine liposome group was treated with bupivacaine liposome 133 mg combined with bupivacaine 25 mg, and the standard control group was treated with 0.5% bupivacaine hydrochloride 75 mg combined with dexamethasone 5 mg, and both groups were perfused with saline 30 ml. ultrasound-guided rhombic intercostal muscle nerve block was performed for a total of 30 ml. postoperative analgesia was provided using patient-controlled intravenous analgesia (PCIA), and according to the patient's weight and baseline condition, flurbiprofenac 50 mg or tramadol 100 mg rescue analgesia was given every 6 hours when resting VAS score was ≥4. Record cumulative consumption at 72 hours postoperatively. Quality of Recovery Score (QoR-15) at 72 hours postoperatively, Numeric Pain Rating Scale (NRS) at 6 hours to 3 months, and patient satisfaction were recorded. ;
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