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Thoracic paravertebral block with different doses of liposomal bupivacaine versus ropivacaine for postoperative analgesia in single-port thoracoscopic lung surgery: a randomized clinical trial.

Liyuan Ren·Zhenhua Nan·Yanshuang Li·Yanping Wang
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Abstract

OBJECTIVE: To evaluate the analgesic efficacy of thoracic paravertebral block (TPVB) with different doses of liposomal bupivacaine (LB) or ropivacaine in patients undergoing single-port thoracoscopic lung surgery. METHODS: A total of 105 patients scheduled for video-assisted single-port thoracoscopic lung surgery were randomized in a 1:1:1 ratio into three groups: low-dose LB group (group LL), high-dose LB group (group HL), or ropivacaine group (group R). All received ultrasound-guided TPVB at the T5/6 level preoperatively. The primary outcome was the area under the curve (AUC) of NRS of pain at activity (AUC-aNRS) from 1 to 72&#x2009;h postoperatively. Secondary outcomes included the AUC of NRS of pain at rest (AUC-rNRS) from 1 to 72&#x2009;h postoperatively, NRS of pain at rest and at activity at 1, 6, 24, 48, and 72&#x2009;h postoperatively, and the cumulative opioid consumption at 24, 48, and 72&#x2009;h postoperatively. Additionally, postoperative recovery and adverse events were assessed. RESULTS: AUC-aNRS differed significantly among groups (p = 0.0092), with high-dose LB lower than low-dose LB (p = 0.0071), but not versus ropivacaine. No significant difference was found in AUC-rNRS (p&#x2009;>&#x2009;0.05). The group-by-time interactions for NRS of pain at rest and at activity were not significant (p&#x2009;>&#x2009;0.05). Cumulative opioid consumption at 24, 48, and 72&#x202f;h was lower in group HL versus group LL (all p < 0.017), but not versus ropivacaine. Postoperative recovery and adverse events showed no differences (p&#x2009;>&#x2009;0.05). CONCLUSION: LB combined with TPVB is not superior to ropivacaine for postoperative analgesia in single-port thoracoscopic lung resection.

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HumansRopivacainePostoperative PainFemaleBupivacaineMiddle AgedMaleAnesthetics, LocalNerve BlockAgedLiposomesThoracic Surgery, Video-AssistedPain MeasurementTreatment OutcomeLungAmidesDose-Response Relationship, DrugAdultLiposomal bupivacainepainropivacainethoracic paravertebral blockJournal ArticleRandomized Controlled TrialComparative StudyResearch Support, Non-U.S. Gov't

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Liyuan Ren, Zhenhua Nan, Yanshuang Li, Yanping Wang. 2026-06-24. Thoracic paravertebral block with different doses of liposomal bupivacaine versus ropivacaine for postoperative analgesia in single-port thoracoscopic lung surgery: a randomized clinical trial.. https://doi.org/10.1080/07853890.2026.2687941

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Journal Article; Randomized Controlled Trial; Comparative Study; Research Support, Non-U.S. Gov't resourceAdult subjectAged subjectAmides subjectAnesthetics, Local subjectBupivacaine subjectComparative Study subjectDose-Response Relationship, Drug subjectFemale subjectHumans subjectJournal Article subjectLiposomal bupivacaine subjectLiposomes subjectLung subjectMale subjectMiddle Aged subject

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