Continuous rhomboid intercostal nerve block for thoracoscopic postoperative analgesia.

Abstract

BACKGROUND\nRhomboid intercostal block is a new type of plane block used for postoperative analgesia after video-assisted thoracoscopic surgery. We performed a prospective randomized controlled trial to investigate the effects of ultrasound-guided continuous rhomboid intercostal nerve block (CRIB) on the global quality of recovery scores (QoR-40) and postoperative analgesia after video-assisted thoracoscopic surgery.\n\n\nMETHODS\nSixty-six adult patients scheduled for elective unilateral video-assisted thoracoscopic surgery were randomly allocated to group C and group CRIB. In group C, patients were administered patient-controlled intravenous analgesia with sufentanil after operation. Patients in group CRIB received patient-controlled analgesia with ropivacaine CRIB. All patients completed the QoR-40 test during the preoperative evaluation and again 24 h after the operation. Information regarding the 48-h postoperative pain and adverse events were recorded.\n\n\nRESULTS\nThe QoR-40 scores of group C were significantly lower than that of group CRIB (155.4±6.1 vs.172.6±6.3, p<0.001), with a mean difference of -17.2 (95% confidence interval -20.4--13.9) 24 h after operation. The postoperative numerical rating scale scores in group CRIB at 6, 12, 18, and 24 h after the surgery, when patients were at rest, were significantly lower than those in group C (all p< 0.05). The postoperative numerical rating scale scores in group CRIB at 1, 3, 6, 12, 18, 24, and 36 h after surgery, when patients were moving, were significantly lower than that in group C (all p< 0.05).\n\n\nCONCLUSIONS\nIn patients who underwent video-assisted thoracoscopic surgery, continuous rhomboid intercostal nerve block led to improved quality of recovery and postoperative analgesia.