Effect of preoperative thoracic paravertebral nerve block using liposomal bupivacaine combined with drainage-tube patient-controlled analgesia on postoperative pain after thoracoscopic lobectomy: a prospective, multicentre, double-blind, randomized controlled study protocol

Abstract

Backgroud: Thoracic paravertebral nerve block (TPVB) with liposomal bupivacaine (LB) is increasingly used for postoperative pain control in patients undergoing thoracic surgery, but relevant data are scarce, and there are few data on LB-TPVB combined with drainage tube patient-controlled analgesia (PCA). The aim of this study was to explore the effect of LB-TPVB combined with drainage-tube PCA on postoperative pain after thoracoscopic lobectomy. Methods: This is a prospective, multicentre, double-blind, randomized controlled study. Participants will be randomly assigned to the standard bupivacaine (SB) group, SB + drainage-tube PCA (DTA) group, LB group, or LB + DTA group. The primary outcome is the 72-h mean numerical rating scale (NRS) pain score at rest. The target sample size is 228 patients, with 57 patients in each group. Discussion: Our study hypothesizes that preoperative ultrasound-guided thoracic nerve block combined with drainage tube self-controlled analgesia is more effective in reducing postoperative pain following thoracoscopic lobe resection compared to thoracic nerve block alone. Additionally, liposomal bupivacaine was found to be more effective than standard bupivacaine in this context. These results will have implications for improving postoperative analgesia protocols for patients undergoing thoracoscopic lung surgery. Trial registration: ClinicalTrials.gov, NCT06165991. Registered 29 November 2023, https://clinicaltrials.gov/study/NCT06165991.