Drug Design Development and Therapy
Liposomal Bupivacaine Combined with Bupivacaine vs Ropivacaine for Paravertebral Blockade in Single-Port Video-Assisted Thoracoscopic Surgery: A Propensity-Matched Comparison of Postoperative Opioid Use
By 关文川, Guanyu Yang, Jing Sang and 2 others.
Abstract
Objective
To compare the effect of preoperative single-injection paravertebral block using liposomal bupivacaine/bupivacaine mixture versus ropivacaine on cumulative postoperative opioid consumption in patients undergoing thoracic surgery.
Methods
This retrospective cohort study included adult patients who underwent elective single-port video-assisted thoracoscopic surgery (wedge resection, segmentectomy, or lobectomy) between January 2024 and February 2026. Patients received an ultrasound-guided single-injection paravertebral block with either 0.5% ropivacaine (20 mL) or a mixture of 1.3% liposomal bupivacaine (10 mL) and 0.5% standard bupivacaine (10 mL). The primary outcome was cumulative postoperative opioid consumption throughout the hospitalization, delivered via patient-controlled analgesia (PCA) and converted to oral morphine milligram equivalents. Secondary outcomes included pain scores, time to first PCA request, postoperative adverse events, and length of stay. Propensity score matching (1:2) was performed to balance baseline clinical and intraoperative characteristics.
