Effect of liposomal bupivacaine thoracic paravertebral block on postoperative analgesia in patients undergoing video-assisted thoracoscopic surgery: a randomized controlled trial

BACKGROUND: Thoracic paravertebral block (TPVB) can provide effective analgesia for patients undergoing video-assisted thoracoscopic surgery (VATS). However, the duration of analgesia achieved with conventional local anesthetics combined with dexamethasone remains limited. This study aimed to determine if liposomal bupivacaine (LB) is superior to bupivacaine combined with dexamethasone (BD) with respect to duration of postoperative analgesia in VATS patients. METHODS: Adults scheduled for VATS were randomized to treatment with LB or BD. The primary outcome was duration of analgesia. Secondary outcomes involved Numeric Rating Scale (NRS) pain scores, cumulative oxycodone consumption, total intraoperative sufentanil consumption, first times to ambulation and flatus, length of hospital stay, patient satisfaction level, and incidence of adverse reactions. RESULTS: Of 93 total subjects, 78 were randomized into two groups (n=39 each). The LB group demonstrated a significantly prolonged duration of analgesia compared with the BD group (1160.4±403.8 min vs 743.1±216.8 min, p