Liposomal Bupivacaine Versus Bupivacaine Hydrochloride for Intercostal Nerve Blockade in Minimally Invasive Thoracic Surgery

ABSTRACT Objective The objective of this study was to compare the effects of liposomal bupivacaine (Lipo-B) and bupivacaine hydrochloride (B-HCl), in the presence of multimodal analgesia, on postoperative analgesia and opioids consumption in minimally invasive thoracic surgery (MITS) lobectomy. Design Retrospective observational cohort study. Setting Tertiary care cancer center. Participants A total of 60 patients who underwent MITS lobectomy and received intercostal nerve blockade (ICNB) with either 0.66% Lipo-B (n=29) or 0.5% B-HCl (n=31). Interventions All patients received intravenous patient-controlled analgesia for the first 12 h postoperatively, followed by opioids and nonsteroidal anti-inflammatory drugs as needed. Measurements and Main Results Perioperative opioid and nonopioid consumption and pain scores were compared between groups at 12-h intervals for the first 72 h. Between the two groups, there were no statistically significant differences in demographic characteristics, intraoperative (p=0.46) and postoperative opioid consumption, Richmond Agitation-Sedation Scale scores and pain scores upon postanesthesia care unit arrival and 4 h, length of postanesthesia care unit stay (p=0.84), or length of hospital stay (p=0.55). Both groups received intra- and postoperative multimodal analgesia. Conclusions In our cohort, we did not detect a difference in opioid consumption or pain scores in the immediate postoperative period following MITS lobectomy between patients given ICNB with Lipo-B and those given ICNB with B-HCl in the presence of multimodal analgesia.