Comparing Liposomal Bupivacaine and Ropivacaine in Serratus Anterior Plane Block for Thoracoscopic Lobectomy: A Randomized Controlled Trial.

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2025-06-04 eCollection Date: 2025-01-01 DOI:10.2147/DDDT.S513287

Yang Zhang, Wei Li, Aiping Wei, Shibiao Chen, Xiuhong Wang

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引用次数: 0

Abstract

Background: The optimal analgesic regimen after video-assisted thoracoscopic surgery (VATS) is unclear. We aimed to examine whether ultrasound-guided serratus anterior plane block (SAPB) with liposomal bupivacaine could provide continuous and effective analgesic effects for lung cancer patients undergoing VATS.

Methods: A total of 64 patients were randomly allocated to receive either the liposomal bupivacaine (LB group) or the ropivacaine (RO group). The primary outcome was pain score at rest and on movement in the first three days after surgery. The secondary outcomes included intraoperative remifentanil consumption, perioperative consumption of sufentanil and flurbiprofen axetil, time to extubation, time to first bowel movement, time to first flatus, incidence of postoperative nausea and vomiting (PONV), length of intensive care unit (ICU) stay, length of hospital stay, hospitalization costs, and early recovery quality as assessed by QoR-15 score.

Results: The LB group had significantly lower pain scores at rest and on movement at 12h, 24h, 36h, 48h, and 72h after surgery, and lower pain scores on movement at 8h after surgery, when compared with the RO group. Perioperative sufentanil consumption and postoperative flurbiprofen axetil consumption were significantly reduced in the LB group than in the RO group. In addition, compared with the RO group, the LB group had earlier first flatus, mobilization, and urinary catheter removal, shorter ICU stay, lower incidence of PONV, and lower hospitalization costs. The QoR-15 scores in the first three days after surgery were significantly higher in the LB group than in the RO group. There were no statistically significant differences between the two groups regarding time to extubation, intraoperative remifentanil consumption, and length of hospital stay.

Conclusion: Ultrasound-guided SAPB with liposomal bupivacaine was effective in relieving postoperative pain for three days after surgery in patients undergoing VATS.

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比较布比卡因和罗哌卡因脂质体在胸腔镜肺叶切除术Serratus前平面阻滞中的应用：一项随机对照试验。

背景：视频胸腔镜手术（VATS）后的最佳镇痛方案尚不清楚。我们的目的是探讨超声引导下布比卡因脂质体下锯肌前平面阻滞（SAPB）是否能为肺癌VATS患者提供持续有效的镇痛效果。方法：64例患者随机分为布比卡因脂质体组（LB组）和罗哌卡因脂质体组（RO组）。主要结果是术后前三天休息和活动时的疼痛评分。次要结局包括术中瑞芬太尼用量、围术期舒芬太尼和氟比洛芬酯用量、拔管时间、第一次排便时间、第一次放屁时间、术后恶心呕吐发生率、重症监护病房（ICU）住院时间、住院时间、住院费用和QoR-15评分评估的早期恢复质量。结果：与RO组相比，LB组术后12h、24h、36h、48h、72h休息和活动疼痛评分明显降低，术后8h活动疼痛评分明显降低。LB组围手术期舒芬太尼用量和术后氟比洛芬酯用量明显低于RO组。此外，与RO组相比，LB组首次放屁、活动、拔尿时间更早，ICU住院时间更短，PONV发生率更低，住院费用更低。术后前3天，LB组QoR-15评分明显高于RO组。两组患者拔管时间、术中瑞芬太尼用量、住院时间差异无统计学意义。结论：超声引导下布比卡因脂质体SAPB能有效缓解VATS患者术后3天的疼痛。

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.