Comparison of Bupivacaine Liposomal vs Bupivacaine Combined With Dexamethasone for Postoperative Pain in VATS

Last updated: June 28, 2025
Sponsor: Affiliated Hospital of Jiaxing University
Overall Status: Completed

Phase

N/A

Condition

Spinal Surgery

Cardiac Surgery

Thoracotomy

Treatment

Rhombic intercostal nerve block(Received liposomal bupivacaine 10 ml 133 mg and 0.5% bupivacaine 5 ml diluted to 25 ml)

Rhombic intercostal nerve block(Received liposomal bupivacaine 10 ml 133 mg and 0.5% bupivacaine 5 ml diluted to 30 ml)

Rhombic intercostal nerve block(Received liposomal bupivacaine 93 mg and bupivacaine 25 mg diluted to 20 ml)

Clinical Study ID

NCT06392191
2024-KY-226
  • Ages 18-80
  • All Genders
  • Accepts Healthy Volunteers

Study Summary

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.

Eligibility Criteria

Inclusion

Inclusion Criteria:

ASA physical status I-III, aged between 18 and 80 years, scheduled for elective thoracoscopic lung resection surgery under general anesthesia with endotracheal intubation (including wedge resection, segmentectomy, or lobectomy) with one or three incisions, expected duration of surgery less than 4 hours, and body mass index (BMI) between 18 and 30 kg/m².

Exclusion

Exclusion Criteria:

  1. trauma or emergency patients;

  2. patients classified as New York Heart Association (NYHA) functional class 3-4;

  3. unstable coronary artery disease patients;

  4. patients with renal system diseases (estimated glomerular filtration rate <30mL/min/1.73 m²);

  5. patients with liver system diseases (alanine aminotransferase or aspartateaminotransferase levels exceeding twice the normal value);

  6. patients with coagulation disorders, or those who have not discontinued warfarin ornovel anticoagulants (such as rivaroxaban, dabigatran) prior to surgery;

  7. individuals with a history of alcohol abuse or substance dependence within the pasttwo months;

  8. patients with uncontrolled anxiety, schizophrenia, or other psychiatric disorders;

  9. pregnant or planning to become pregnant women;

  10. individuals with a history of allergy to local anesthetics or investigational drugs.Additionally, patients who refuse to sign the informed consent form will also beexcluded;

  11. chronic pain syndromes (defined as reflex sympathetic dystrophy or complex regionalpain syndrome);

  12. chronic opioid use (longer than 3 months or daily morphine equivalents more than 5mg/day for 1 month).

Study Design

Total Participants: 148
Treatment Group(s): 6
Primary Treatment: Rhombic intercostal nerve block(Received liposomal bupivacaine 10 ml 133 mg and 0.5% bupivacaine 5 ml diluted to 25 ml)
Phase:
Study Start date:
November 10, 2024
Estimated Completion Date:
May 02, 2025

Study Description

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 90 elective thoracoscopic lung resection surgery(including wedge resection, segmentectomy, or lobectomy) patients between the ages of 18-80 years, ASA Physical Status I and III, who 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 93 mg combined with bupivacaine 25 mg, and the standard control group was treated with bupivacaine hydrochloride 105 mg combined with dexamethasone 5 mg, and both groups were perfused with saline 20 ml. ultrasound-guided rhombic intercostal muscle nerve block was performed for a total of 20 ml. postoperative analgesia was provided using patient-controlled intravenous analgesia (PCIA), and according to the patients weight and baseline condition. Upon arrival of postoperative patients to the ward, if the patient reports significant pain, defined as the numeric rating scale (NRS), score greater than 3, the first step is to administer one press of the analgesic pump. If the pain persists, the pain management protocol will be initiated. Cumulative PCIA consumption at different postoperative time intervals (including 0-24 hours, 24-48 hours, and 48-72 hours). Quality of Recovery Score (QoR-15) at 72 hours postoperatively, If NRS at 6 hours to 3 months, and patient satisfaction were recorded.Pain assessments were performed at the following time points: 0 hours postoperatively (upon tracheal extubation and patient awakening), 0.5 hours, 2 hours, 4 hours, 12 hours, 24 hours, 48 hours, and 72 hours. Pain score follow-up by telephone at the third month.

Connect with a study center

  • The First Hospital of Jiaxing

    Jiaxing, Zhejiang 942111
    China

    Site Not Available

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