Abstract
Thoracoscopic minimally invasive surgery is widely recognized for its efficacy in pain management. Nevertheless, postoperative pain control continues to pose a significant challenge in thoracic surgery. The objective of this study was to investigate the impact of bupivacaine liposomes on postoperative pain management in patients undergoing thoracoscopic lung surgery. All patients who underwent thoracoscopic surgery between March 2024 and October 2024 were retrospectively analyzed. In the patient controlled intravenous analgesia (PCIA) group, a total of 171 patients received thoracoscopic pneumonectomy without intrapleural intercostal nerve block (INB). Conversely, in the bupivacaine liposome (BL) group, another set of 171 patients underwent thoracoscopic minimally invasive surgery with intrapleural intercostal nerve infiltration anesthesia. Pain scores, measured using the Numerical Rating Scale (NRS), were recorded on the day following surgery as well as on days 1, 2, and 3 postoperatively or at the time of discharge. Additionally, we documented both postoperative analgesic consumption and any temporary emergency analgesics administered. Length of stay (LOS) and occurrences of postoperative arrhythmia were compared between the two groups. Among 342 patients undergoing thoracoscopic minimally invasive lung surgery, the LOS in the BL group was nearly half a day shorter (12.24 h) compared to the PCIA group. The consumption of postoperative analgesics in the BL group was significantly lower than that observed in the PCIA group (P = 0.038). Additionally, there were more instances of rescue analgesic use in the PCIA group than in the BL group. In patients undergoing thoracoscopic lung surgery, the administration of intrapleural intercostal nerve block utilizing bupivacaine liposome can alleviate postoperative pain and reduce the need for analgesics following the procedure. This method represents a safe adjunctive treatment for the pain management of postoperative pulmonary surgery.