实用医学杂志2026，Vol.42Issue(6)：916-922,7.DOI:10.3969/j.issn.1006-5725.2026.06.002
布比卡因脂质体胸腔镜引导下肋间神经阻滞对胸腔镜肺叶切除术后镇痛效果的影响
Evaluation of postoperative analgesic efficacy of liposomal bupivacaine in thoracoscopy-guided intercostal nerve block
摘要
Abstract
Objective To compare the effects of liposomal bupivacaine and ropivacaine in thoracoscopy-guided intercostal nerve block(TINB)on postoperative analgesia and recovery quality in patients undergoing video-assisted thoracoscopic lobectomy(VATS).Methods A total of 120 patients who were scheduled for VATS lobec-tomy under general anesthesia from January to June 2025 were recruited and randomly allocated into the liposomal bupivacaine group(Group L,266 mg/20 mL,n=60)and the ropivacaine group(Group R,100 mg/20 mL,n=60).In both groups,thoracic intercostal nerve block(INB)at the T4—T8 level was performed under direct thoraco-scopic visualization,followed by 72-hour patient-controlled intravenous analgesia(PCIA).The resting and activity Numeric Rating Scale(NRS)scores at 2,6,12,24,48,and 72 hours post-surgery were recorded.The total sufentanil consumption,the time to the first PCIA demand,the rescue analgesia rate,the time to the first ambula-tion,the duration of chest tube placement,the total effective PCIA presses within 72 hours,the Quality of Recovery-15(QoR-15)scores at 24 hours before surgery and 24/72 hours after surgery,as well as the incidences of nausea/vomiting,pulmonary complications,and INB-related adverse events were documented.Results Compared with Group R,Group L exhibited significantly lower resting NRS scores at 12,24,48,and 72 h and activity NRS scores at 12,24,and 48 h(P＜0.05).Additionally,it showed significantly reduced total sufentanil consumption,a prolonged time to the first PCIA demand,a shorter time to the first ambulation,a reduced rescue analgesia rate,decreased effective PCIA presses during the 0～24,24～48,and 48～72 h intervals(P＜0.05),higher QoR-15 scores at 24/72 h(P＜0.05),and a significantly lower nausea/vomiting incidence(P＜0.05).There were no inter-group differences in the chest tube duration or the incidences of pulmonary complications and other adverse events(P＞0.05).Moreover,neither group encountered nerve block-related complications.Conclusion Liposomal bupivacaine TINB offers 72-hour prolonged analgesia,significantly decreases opioid consumption,improves the quality of early recovery with fewer adverse effects,and thus represents an optimized option for postoperative analgesia in VATS.关键词
布比卡因脂质体/罗哌卡因/肋间神经阻滞/术后镇痛/胸腔镜下肺叶切除术Key words
liposomal bupivacaine/ropivacaine/intercostal nerve block/postoperative analgesia/video-assisted thoracoscopic lobectomy分类
医药卫生引用本文复制引用
刘世娅,郭怡辛,刘文铜,尹航,崔益宁,卢锡华..布比卡因脂质体胸腔镜引导下肋间神经阻滞对胸腔镜肺叶切除术后镇痛效果的影响[J].实用医学杂志,2026,42(6):916-922,7.基金项目
国家临床重点专科建设项目(编号:豫卫医函[2023]30号) （编号:豫卫医函[2023]30号）
